Browsing by Author "Uysal B."

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    Bone marrow radiation dosimetry of high dose 131I treatment in differentiated thyroid carcinoma patients
    (Novin Medical Radiation Institute, 2016) Parlak Y.; Demir M.; Cavdar I.; Ereees S.; Gumuser G.; Uysal B.; Kaya G.C.; Koç M.; Sayit E.
    Background: Radiation absorbed dose to the red bone marrow, a critical organ in the therapy of thyroid carcinoma, is generally kept below 2 Gy for non-myeloablative therapies. The aim of this study was to calculate bone marrow radiation dose by using MIRDOSE3 package program and to optimize the safe limit of acivity to be administered to the thyroid cancer paients. Materials and Methods: In this study, 83 thyroid cancer patients were divided into 3 groups based on the amount of acivity administered into the body. In the groups, 3700 MBq, 5550 MBq and 7400 MBq activities were used respecively. The curves of ime-acivity were drawn from blood samples counts and effective half-life and residence time were calculated. Correlations of bone marrow radiation dose and radioiodine effective half-life were determined as a function of administered activity via ANOVA test. Tg levels and tumour diameters were compared using Spearman's correlation. Results: The effective half-lives of 131I for three groups of whole-body, receiving 3700 MBq, 5550 MBq and 7400 MBq were calculated as 20.57±5.4, 17.8±5.8 and 18.7±3.9 hours, respectively. The average bone marrow doses for 3 groups of patients were 0.32±0.08 Gy, 0.42±0.14 Gy and 0.60±0.24 Gy, respectively. Conclusion: It was concluded that, the bone marrow dose to the patients still remains within the recommended level even after administering an activity of 7400 MBq of 131I to the patients.
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    Radiation Safety Guide: General Definitions and Radiation Protection Rules in Nuclear Medicine Applications
    (Galenos Publishing House, 2020) Parlak Y.; Uysal B.; Kıraç F.S.; Kovan B.; Demir M.; Ayan A.; Poyraz L.; Özaslan İ.A.; Köseoğlu K.; Yeyin N.; Dönmez S.
    Ionizing radiation which is widely used in the field of medicine and industry, and in scientific studies leaves some or all of its energy to the tissue as it passes through living tissue. It causes known possible harmful effects on living organisms, from low exposure doses to high doses. These are stochastic effects (cancer, mutations) and deterministic effects which are recently named as tissue reactions (such as dermatitis, cataracts). It is important to keep the radiation exposure of the radiation workers and the public as low as possible and to keep within the acceptable dose limits in order to avoid unknown harmful effects. Radiation risks to health are assessed by radiation absorbed dose, dose equivalent and effective doses. In routine daily practices, as low as reasonably achievable dose and as low as reasonably practible dose principles, and also, occupational and public permissible dose limits defined by international and national atomic energy agencies should be complied. Radiation protection rules should be followed to reduce an exposure dose as much as possible while working in the radiation areas. Radiation accidents, transportation of radioactive materials and radioactive waste disposal are important special issues for the protection of environmental health, and compliance with radiation protection rules are necessary. With the development of new targeted radiopharmaceuticals, radionuclide treatments are frequently applied in nuclear medicine clinics, especially in the treatment of malignant diseases. Therefore, radiation protection is an important issue especially for the hospital workers performing procedures to the patients who die shortly after administration of high-dose radionuclide therapy. In this guide, the terms related to radiation will be presented at first, and then, the national and international radiation protection rules in radiation works will be given. © Telif Hakkı 2020 Türkiye Nükleer Tıp Derneği / Nükleer Tıp Seminerleri, Galenos Yayınevi tarafından yayınlanmıştır.
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    A nationwide retrospective study in Turkish children with nephrocalcinosis
    (NLM (Medline), 2021) Döven S.S.; Tülpar S.; Baştuğ F.; Yıldırım Z.N.Y.; Yılmaz E.K.; Çiçek N.; Küçük N.; Çomak E.; Yazıcıoğlu B.; Nalçacıoğlu H.; Delibaş A.; Uysal B.; Ağbaş A.; Gemici A.; Günay N.; Ertan P.; Bıyıklı N.; Hacıhamdioğlu D.Ö.; Elmacı A.M.; Atikel Y.Ö.; Delebe E.ÖÇ.; Sever F.L.; Gökçe İ.; Öner N.; Akman S.; Aksu B.; Atmış B.; Yel S.; Yılmaz A.; Çelik B.; Dursun İ.; Alpay H.
    BACKGROUND: Nephrocalcinosis (NC) is defined as calcium deposition in the kidney parenchyma and tubules. This study aims to determine the etiology, risk factors, and follow-up results of patients with NC in Turkey. METHODS: Patients diagnosed with NC in the pediatric nephrology Department Units of 19 centers from all geographical regions of Turkey over a 10-year period (2010-2019) were included in the study. The medical records from the centers were reviewed and demographic data, admission complaints, medical history, systemic and genetic disorders, risk factors for NC, treatment details, and presence of NC after one-year follow-up, were recorded retrospectively. RESULTS: The study sample included 195 patients (88 females, 107 males). The mean age at diagnosis was 39.44 ± 47.25 (0.5-208) months; 82/190 patients (43.2%) were diagnosed incidentally; 46/195 patients (23.6%) had an underlying disease; idiopathic hypercalciuria was detected in 75/195 (38.4%) patients. The most common systemic diseases were distal renal tubular acidosis in 11/46 patients (23.9%), primary hyperoxaluria in 9/46 patients (19.6%) and Bartter syndrome in 7/46 patients (15.3%). After one year of follow-up, NC resolved in 56/159 patients (35.2%) and they all did not have an underlying systemic disease. DISCUSSION: The most common presentation of NC was incidental. Distal renal tubular acidosis and primary hyperoxaluria were the main systemic diseases leading to NC, while hypercalciuria was the most common metabolic risk factor. Nephrocalcinosis was found to remain in most of the patients at a one-year follow-up. It may resolve particularly in patients with no underlying systemic disease.
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    Comparison of infants and children with urolithiasis: a large case series
    (Springer Science and Business Media Deutschland GmbH, 2022) Baştuğ F.; Ağbaş A.; Tülpar S.; Yıldırım Z.N.Y.; Çiçek N.; Günay N.; Gemici A.; Çelik B.; Delebe E.Ö.Ç.; Nalçacıoğlu H.; Yılmaz A.; Gökçe İ.; Demircin G.; Hacıhamdioğlu D.Ö.; Yılmaz K.; Atmış B.; Yılmaz E.K.; Ertan P.; Dursun İ.; Aksu B.; Akbulut B.B.; Döven S.S.; Öner N.; Yel S.; Elmacı A.M.; Atikel Y.Ö.; Erfidan G.; Uysal B.; Bıyıklı N.; Yazıcıoğlu B.; Küçük N.; Çomak E.; Sever F.L.; Akil İ.; Aksoy Ö.; Alpay H.
    We evaluated the demographic features, etiologic risk factors, treatment strategies, and outcome of the infants and children with urolithiasis (UL). A retrospective multicenter study was conducted including 23 Pediatric Nephrology centers in Turkey. The medical records of 2513 children with UL were reviewed. One thousand, three hundred and four boys and 1209 girls (1.1:1) were reported. The mean age at diagnosis was 39.5 ± 35 months (0.4–231 months), and 1262 patients (50.2%) were in the first year of life (infants). Most of the cases with infantile UL were diagnosed incidentally. Microlithiasis (< 3 mm) was found in 794 patients (31.6%), and 64.5% of the patients with microlithiasis were infants. Stones were located in the pelvis-calyces in 63.2% (n: 1530) of the cases. The most common stone type was calcium oxalate (64.6%). Hypocitraturia was the most common metabolic risk factor (MRF) in children older than 12 months, but in infancy, hypercalciuria was more common. Fifty-five percent of the patients had received at least one medical treatment, mostly potassium citrate. At the end of a year’s follow-up, most of the patients with microlithiasis (85%) showed spontaneous remission. The rate of spontaneous stone resolution in infants was higher than in children. Spontaneous remission rate was higher in cases with MRF (− ) stones than in MRF (+) stones. However, remission rate with medical treatment was higher in cases with MRF (+) stones. This study represents the results of a large series of infants and children with UL and showed that there are several differences such as underlying metabolic and anatomic abnormalities, clinical course, and stone remission rates between infants and children with urinary stone disease. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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    Kidney disease profile and encountered problems during follow-up in Syrian refugee children: a multicenter retrospective study
    (Springer Science and Business Media Deutschland GmbH, 2022) Balat A.; Kilic B.D.; Aksu B.; Kara M.A.; Buyukcelik M.; Agbas A.; Eroglu F.K.; Gungor T.; Alaygut D.; Yildiz N.; Bastug F.; Atmis B.; Melek E.; Elmaci M.; Tulpar S.; Pehlivanoglu C.; Doven S.S.; Comak E.; Tabel Y.; Gemici A.; Uysal B.; Ozzorlar G.S.; Kuçuk N.; Delibas A.; Ozcelik G.; Goknar N.; Dursun I.; Ertan P.; Ozunan I.A.; Sonmez F.
    Background: Children are one of the most vulnerable groups in conflict zones, especially those with chronic diseases. This study aimed to investigate kidney disease profiles and problems during follow-up in a population of Syrian refugee children residing in Turkey. Methods: Syrian refugee children aged between 0 and 18 years were included in the study. Demographic data, diagnosis, particular interventions due to nephrological problems, and problems encountered during follow-up were obtained from all participating pediatric nephrology centers. Results: Data from 633 children from 22 pediatric nephrology centers were included. Mean age of the children was 94.8 ± 61.7 months and 375 were male (59%). 57.7% had parental consanguinity and 23.3% had a close relative(s) with kidney disease. The most common kidney diseases were congenital anomalies of the kidney and urinary tract (CAKUT) (31.0%), glomerular disease (19.9%), chronic kidney disease (CKD) (14.8%), and urolithiasis (10.7%). Frequent reasons for CAKUT were nonobstructive hydronephrosis (23.0%), vesico-ureteral reflux (18.4%), and neurogenic bladder (15.8%). The most common etiology of glomerular diseases was nephrotic syndrome (69%). Ninety-four children had CKD, and 58 children were on chronic dialysis. Six children had kidney transplantation. Surgical intervention was performed on 111 patients. The language barrier, lack of medical records, and frequent disruptions in periodic follow-ups were the main problems noted. Conclusions: CAKUT, glomerular disease, and CKD were highly prevalent in Syrian refugee children. Knowing the frequency of chronic diseases and the problems encountered in refugees would facilitate better treatment options and preventive measures. © 2021, IPNA.
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    Urinary HSP70 improves diagnostic accuracy for urinary tract infection in children: UTILISE study
    (Springer Science and Business Media Deutschland GmbH, 2023) Yilmaz A.; Afonso A.C.; Akil I.; Aksu B.; Alpay H.; Atmis B.; Aydog O.; Bayazıt A.K.; Bayram M.T.; Bilge I.; Bulut I.K.; Buyukkaragoz B.; Comak E.; Demir B.K.; Dincel N.; Donmez O.; Durmus M.A.; Dursun H.; Dusunsel R.; Duzova A.; Ertan P.; Gedikbasi A.; Goknar N.; Guven S.; Hacihamdioglu D.; Jankauskiene A.; Kalyoncu M.; Kavukcu S.; Kenan B.U.; Kucuk N.; Kural B.; Litwin M.; Montini G.; Morello W.; Nayir A.; Obrycki L.; Omer B.; Ozdemir E.M.; 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 O.N.; Uysal B.; Uysalol M.; Vaiciuniene D.; Yavuz S.; Yel S.; Yildirim T.; Yildirim Z.Y.; Yildiz N.; Yuksel S.; Yurtseven E.; Schaefer F.; Topaloglu R.
    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. Graphical abstract: A higher resolution version of the Graphical abstract is available as Supplementary information [Figure not available: see fulltext.] © 2022, The Author(s), under exclusive licence to International Pediatric Nephrology Association.
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    The relationship between urine heat shock protein 70 and congenital anomalies of the kidney and urinary tract: UTILISE study
    (Frontiers Media SA, 2023) Aksu B.; Afonso A.C.; Akil I.; Alpay H.; Atmis B.; Aydog O.; Bakkaloglu S.; Bayazıt A.K.; Bayram M.T.; Bilge I.; Bulut I.K.; Cetinkaya A.P.G.; Comak E.; Demir B.K.; Dincel N.; Donmez O.; Durmus M.A.; Dursun H.; Dusunsel R.; Duzova A.; Ertan P.; Gedikbasi A.; Goknar N.; Guven S.; Hacihamdioglu D.; Jankauskiene A.; Kalyoncu M.; Kavukcu S.; Kenan B.U.; Kucuk N.; Kural B.; Litwin M.; Montini G.; Morello W.; Obrycki L.; Omer B.; Misirli Ozdemir E.; 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 O.N.; Uysal B.; Uysalol M.; Vitkevic R.; Yavuz S.; Yel S.; Yildirim T.; Yildirim Z.Y.; 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. Copyright © 2024 Aksu, Afonso, Akil, Alpay, Atmis, Aydog, Bakkaloglu, Bayazıt, Bayram, Bilge, Bulut, Cetinkaya, Comak, Demir, Dincel, Donmez, Durmus, Dursun, Dusunsel, Duzova, Ertan, Gedikbasi, Goknar, Guven, Hacihamdioglu, Jankauskiene, Kalyoncu, Kavukcu, Kenan, Kucuk, Kural, Litwin, Montini, Morello, Obrycki, Omer, Misirli Ozdemir, Ozkayin, Paripovic, Pehlivanoglu, Saygili, Schaefer, Schaefer, Sonmez, Tabel, Tas, Tasdemir, Teixeira, Tekcan, Topaloglu, Tulpar, Turkkan, Uysal, Uysalol, Vitkevic, Yavuz, Yel, Yildirim, Yildirim, Yildiz, Yuksel, Yurtseven and Yilmaz.
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    Urine soluble TLR4 levels may contribute to predict urinary tract infection in children: the UTILISE Study
    (Springer Science and Business Media Deutschland GmbH, 2024) Aksu B.; Afonso A.C.; Akil I.; Alpay H.; Atmis B.; Aydog O.; Bayazıt A.K.; Bayram M.T.; Bilge I.; Bulut I.K.; Buyukkaragoz B.; Comak E.; Demir B.K.; Dincel N.; Donmez O.; Durmus M.A.; Dursun H.; Dusunsel R.; Duzova A.; Ertan P.; Gedikbasi A.; Goknar N.; Guven S.; Hacihamdioglu D.; Jankauskiene A.; Kalyoncu M.; Kavukcu S.; Kenan B.U.; Kucuk N.; Kural B.; Litwin M.; Montini G.; Morello W.; Obrycki L.; Omer B.; Oner H.A.; Ozdemir E.M.; 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 O.N.; Uysal B.; Uysalol M.; Vitkevic R.; Yavuz S.; Yel S.; Yildirim T.; Yildirim Z.Y.; 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. Graphical abstract: [Figure not available: see fulltext.]. © 2023, The Author(s), under exclusive licence to International Pediatric Nephrology Association.