Browsing by Author "Yavuz, S"

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    Modeling approach and analysis time comparison of single-link flexible steel- and epoxy-glass/carbon-fiber composite manipulators
    Yavuz, S; Ilman, MM; Binici, B
    This paper presents different modeling technique approaches of the single-link uniform cross-sectional shape manipulators. Three different materials of manipulators which are epoxy-glass and carbon-fiber for composite manipulators and steel manipulator are considered for both simulation and experimental analyses. Three different modelling techniques which are solid, beam and shell models are used for both manipulators. The study consists of three steps. In the first step, the manipulators are modeled in ANSYS for finite element analyses. In the second step, modal analysis is carried out in order to find the frequencies of the manipulators. In the third step, transient analysis is performed to investigate the success of different modeling approaches with experimental results. It is observed that the simulation results with three different modeling approaches have well matched with the experimental results and then, elapsed times for the transient analyses are investigated to find the appropriate modeling technique for the manipulator.
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    Stress and rigidity comparison and improved vibration control of flexible carbon-fiber and epoxy-glass composite manipulators under end-point load
    Yavuz, S; Ilman, MM
    This paper presents the vibration control problem of the single-link flexible composite manipulators. Two different materials of composite which are epoxy-glass and carbon-fiber are considered for both simulation and experimental analyses. Manipulators are obliged to perform a job such as pick and place applications and machining a workpiece. Therefore, a payload is attached to the manipulators. If the system is suitable for loading applications, the improved vibration control method is used to suppress the residual vibrations of the manipulators. The simulation results are verified with experimental results and it is observed that the proposed vibration control method significantly reduces the residual vibrations compared to passive vibration control method in literature. Additionally, the stresses during motion are analyzed for both simulation and experiment and the effectiveness of the proposed method on the stresses is investigated. Results showed that only the carbon-fiber manipulator is suitable for payload applications and its utilization efficiency can be greatly improved by the proposed method.
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    Modified reduced-order modeling of a flexible robot-manipulator and model-associative vibration control implementation
    Yavuz, S; Ilman, MM
    This paper introduces a modified reduced-order model with aim to use in the dynamic analysis of flexible robot-manipulators. The model structure is firstly discussed theoretically, then numerically, and finally experimentally in terms of efficiency, utility and robustness. Due to the deterministic structure of the model, which is formed by taking into account the specific features of the system, a successful model can be created without the need for wide range of training data such in probabilistic methods. Because of the simplicity of the model, it is able to realize a dramatic decrease in the analysis period compared to FEA programs. The model is also quite successful in reflecting the robot's nonlinear trigonometric position responses. Besides, an open loop model-associative vibration control method was used to show the utility and satisfactory results were achieved in the actual system. Furthermore, the ability of the model to perform multiple scenarios in a short time allowed the case-study of the control input parameters. (C) 2020 Elsevier Ltd. All rights reserved.
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    Optical and photovoltaic properties of salicylaldimine-based azo ligands
    Dinçalp, H; Yavuz, S; Hakli, Ö; Zafer, C; Özsoy, C; Durucasu, I; Içli, S
    A series of azo dyes containing salicylaldimine-based ligands as side chains were prepared and characterized. Absorption and emission data in five solvents of different polarities were studied. Photoirradiation studies under an oxygen atmosphere in water showed that the Schiff base side chains enhanced the photo-oxidative stability of the azo chromophore. The electrochemical properties of the dyes were investigated by a cyclic voltammetry. The synthesized salicylaldimine-based azo dyes gave two irreversible oxidation potentials. Complexation behavior of synthesized compounds with titanium (IV) ions was illustrated by the change in their absorption spectra. These ligands are appropriate sensitizers for anchoring to the TiO2 surface chemically in dye-sensitized solar cell (DSSC) productions. Electron injection capacities to TiO2 and photovoltaic performance of the synthesized salicylaidimine-based azo dyes were tested with DSSC. (C) 2009 Elsevier B.V. All rights reserved.
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    Hybrid vibration control of an industrial CFRP composite robot-manipulator system based on reduced order model
    Ilman, MM; Yavuz, S; Karagülle, H; Uysal, A
    This paper introduces a novel hybrid vibration control of an industrial flexible link manipulator (FLM) with carbon-fiber reinforced polymer (CFRP) composite material. The hybrid controller consists of a closed-loop direct strain feedback controller (DSFC) and a new open-loop input shaper (OLIS), and its performance is examined and compared by numerical simulation and experiment. Vibration attenuation is also verified by a spare sensor, an accelerometer. Thanks to the design of an analog isolator circuit, data acquisition of the real-time experiments are carried out noise-free from the servo driver. Reduced-order-model (ROM) is generated for the composite link with three different loading conditions and model for servo system is derived via system identification. Impulse force test hammer (IFTH) equipment is used to excite the system with force input and the results of the experiments/simulations confirm that the controller is robust against the impulse disturbances. As a result, a decrease of 88 +/- 6.9 percent in vibration amplitudes and a decrease of 90 +/- 7 percent in vibration duration confirms that the proposed controller is effective for vibration control of the flexible arm even under disturbance. Controller performance also enabled the FLM to work with payloads 16 times of its own weight.
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    Attitudes toward Wife Abuse of Police Officers and Judiciary Members in Turkey: Profession, Gender, Ambivalent Sexism and Sex Roles
    Gölge, ZB; Sanal, Y; Yavuz, S; Arslanoglu-Çetin, E
    This study examined the attitudes of police officers and judiciary members toward wife abuse in Turkey and the relation between these attitudes and profession, ambivalent sexism (hostile/benevolent sexism), gender, and gender roles. The following instruments were used for the analyses: The Attitudes Toward Wife Abuse Scale (AWAS), the Ambivalent Sexism Inventory (ASI), and the Bem Sex Role Inventory. The participants were 300 police officers and 150 judiciary members selected from different regions of Turkey. Results showed that compared to judiciary members, police officers are more tolerant of physical and verbal abuse of women in marriage, but less tolerant of the idea of the victim leaving an abusive marriage partner. Similarly, men were more tolerant than women of those husbands who physically and verbally abuse their wives, but less supportive of the wife leaving the abusive partner. Profession and ambivalent sexism (hostile/benevolent sexism) were found to be the strongest predictors of attitudes toward wife abuse.
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    Criminal and Legal Responsibilities in Tourette's Syndrome
    Gullucayir, S; Asirdizer, M; Yavuz, S; Zeyfeoglu, Y; Ulucay, T
    Tourette's Syndrome (TS) is a neuropsychological disorder characterized by the presence of multiple involuntary motor tics accompanied by one or more vocal tics. Articles about TS and criminal responsibility and the restriction of civil rights are limited. A person with TS was evaluated to consider his criminal responsibility after swearing at a referee during a football game. He was also evaluated as to whether or not he was capable of professionally driving a service bus. Additionally, medico-legal situations regarding military service, obtaining a shotgun license and marriages of patients with TS were considered.
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    Measurement of Rectal Diameter and Anterior Wall Thickness by Ultrasonography in Children with Chronic Constipation
    Dogan, G; Keçeli, M; Yavuz, S; Topçu, A; Kasirga, E
    Background: Measurement of rectal diameter by ultrasonography helps the clinician in the diagnosis of chronic constipation in children for whom rectal examination cannot be performed. The aim of the study is to determine the rectal diameter and anterior wall thickness values in constipated and healthy children and to evaluate the feasibility of ultrasonography in the diagnosis of functional constipation in children who refuse digital rectal examination. Methods: One hundred forty constipated and 164 healthy children participated in the study. All patients were divided into 4 subgroups according to their ages (<= 3 years [group I], 3.1-6 years [group II], 6.1-12 years [group III], and >12 years [group IV]) and were referred to the radiology department. The measurement was made from above the symphysis pubis, under the ischial spine, and at the bladder neck. Anterior wall thickness measurement was performed. The measurements were recorded according to the presence or absence of fecal mass in the rectum. Results: Constipated children with fecal mass positive group III was found to have significant difference in all of the planes in rectal diameter measurement. Rectum anterior wall thickness measurement was found to be higher in constipated patients with fecal mass (+) compared to the control. Its measurements in constipated patients in group II, group III, and group IV with no fecal mass were found to be statistically higher than the control group. Conclusion: The measurement of rectal diameter and anterior wall thickness by ultrasonography as a noninvasive method was performed in children who did not want the digital rectal examination, and it may be useful in the diagnosis of constipation.
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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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    Pediatric kidney care experience after the 2023 Türkiye earthquake
    Bakkaloglu, SA; Delibas, A; Döven, SS; Taner, S; Yavuz, S; Erfidan, G; Vatansever, ED; Aynaci, F; Yílmaz, K; Tasdemir, M; Akaci, O; Akinci, N; Güven, S; Çiçek, N; Dursun, I; Kelesoglu, E; Sancaktar, M; Alaygut, D; Saygili, S; Yavascan, Ö; Yilmaz, A; Gülleroglu, K; Ertan, P; Demir, BK; Poyrazoglu, H; Pinarbasi, S; Gençler, A; Bastug, F; Günay, N; Çelegen, K; Noyan, A; Parmaksiz, G; Avci, B; Çayci, FS; Bayrakçi, U; Özlü, SG; Aksoy, ÖY; Yel, S; Inal, GA; Köse, S; Bayazit, AK; Atmis, B; Saribas, E; Çagli, Ç; Tabel, Y; Elmas, AT; Selçuk, SZ; Kiliç, BD; Kara, MA; Büyükçelik, M; Balat, A; Tiryaki, BD; Erdogdu, B; Aksu, B; Mahmudova, G; Dursun, H; Candan, C; Göknar, N; Mutlubas, F; Çamlar, SA; Basaran, C; Akbulut, BB; Düzova, A; Gülhan, B; Oruç, Ç; Peru, H; Alpay, H; Türkkan, ÖN; Gülmez, R; Çelakil, M; Dogan, K; Bilge, I; Pehlivanoglu, C; Büyükkaragöz, B; Leventoglu, E; Alpman, N; Zeybek, C; Tülpar, S; Gülsan, RYÇ; Kara, A; Gürgöze, MK; Önder, ENA; Atikel, YÖ; Pul, S; Sönmez, F; Yildiz, G; Akman, S; Elmaci, M; Küçük, N; Yüksel, S; Kavaz, A; Nalçacioglu, H; Alparslan, C; Dinçel, N; Elhan, AH; Sever, L
    Background. Two earthquakes on 6 February 2023 destroyed 10 cities in Turkiye. We report our experience with pediatric victims during these catastrophes, with a focus on crush syndrome related-acute kidney injury (Crush-AKI) and death. Method. Web-based software was prepared. Patient demographics, time under rubble (TUR), admission laboratory data, dialysis, and kidney and overall outcomes were recorded. Results. A total of 903 injured children (median age 11.62 years) were evaluated. Mean TUR was 13 h (interquartile range 32.5, max 240 h). Thirty-one of 32 patients with a TUR of >120 h survived. The patient who was rescued after 10 days survived. Two-thirds of the patients were given 50 mEq/L sodium bicarbonate in 0.45% sodium chloride solution on admission day. Fifty-eight percent of patients were given intravenous fluid (IVF) at a volume of 2000-3000 mL/m(2) body surface area (BSA), 40% at 3000-4000 mL/m(2) BSA and only 2% at >4000 mL/m(2) BSA. A total of 425 patients had surgeries, and 48 suffered from major bleeding. Amputations were recorded in 96 patients. Eighty-two and 66 patients required ventilator and inotropic support, respectively. Crush-AKI developed in 314 patients (36% of all patients). In all, 189 patients were dialyzed. Age >15 years, creatine phosphokinase (CK) >= 20 950 U/L, TUR >= 10 h and the first-day IVF volume <3000-4000 mL/m2 BSA were associated with Crush-AKI development. Twenty-two deaths were recorded, 20 of 22 occurring in patients with Crush-AKI and within the first 4 days of admission. All patients admitted after 7 days survived. Conclusions. These are the most extensive pediatric kidney disaster data obtained after an earthquake. Serum CK level was significantly associated with Crush-AKI at the levels of >20 950 U/L, but not with death. Adolescent age and initial IVF of less than 3000-4000 mL/m(2) BSA were also associated with Crush-AKI. Given that mildly injured victims can survive longer periods in the disaster field, we suggest uninterrupted rescue activity for at least 10 days.
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    Identification of susceptibility loci for Takayasu arteritis through a large multi-ancestral genome-wide association study
    Ortiz-Fernández, L; Saruhan-Direskeneli, G; Alibaz-Oner, F; Kaymaz-Tahra, S; Coit, P; Kong, XF; Kiprianos, AP; Maughan, RT; Aydin, SZ; Aksu, K; Keser, G; Kamali, S; Inanc, M; Springer, J; Akar, S; Onen, F; Akkoc, N; Khalidi, NA; Koening, C; Karadag, O; Kiraz, S; Forbess, L; Langford, CA; McAlear, CA; Ozbalkan, Z; Yavuz, S; Çetin, GY; Alpay-Kanitez, N; Chung, S; Ates, A; Karaaslan, Y; McKinnon-Maksimowicz, K; Monach, PA; Ozer, HTE; Seyahi, E; Fresko, I; Cefle, A; Seo, P; Warrington, KJ; Ozturk, MA; Ytterberg, SR; Cobankara, V; Onat, AM; Duzgun, N; Bicakcigil, M; Yentür, SP; Lally, L; Manfredi, AA; Baldissera, E; Erken, E; Yazici, A; Kisacik, B; Kasifoglu, T; Dalkilic, E; Cuthbertson, D; Pagnoux, C; Sreih, A; Reales, G; Wallace, C; Wren, JD; Cunninghame-Graham, DS; Vyse, TJ; Sun, Y; Chen, HY; Grayson, PC; Tombetti, E; Jiang, LD; Mason, JC; Merkel, PA; Direskeneli, H; Sawalha, AH
    Takayasu arteritis is a rare inflammatory disease of large arteries. We performed a genetic study in Takayasu arteritis comprising 6,670 individuals (1,226 affected individuals) from five different populations. We discovered HLA risk factors and four non-HLA susceptibility loci in VPS8, SVEP1, CFL2, and chr13q21 and reinforced IL12B, PTK2B, and chr21q22 as robust susceptibility loci shared across ancestries. Functional analysis proposed plausible underlying disease mechanisms and pinpointed ETS2 as a potential causal gene for chr21q22 association. We also identified >60 candidate loci with suggestive association (p < 5 x 10(-s)) and devised a genetic risk score for Takayasu arteritis. Takayasu arteritis was compared to hundreds of other traits, revealing the closest genetic relatedness to inflammatory bowel disease. Epigenetic patterns within risk loci suggest roles for monocytes and B cells in Takayasu arteritis. This work enhances understanding of the genetic basis and pathophysiology of Takayasu arteritis and provides clues for potential new therapeutic targets.
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    The Efficacy and Safety of CT-P13 as First-line and Subsequent-line Therapy in Patients with Ankylosing Spondylitis: Real-life Data from TURKBIO Cohort
    Uslu, S; Gulle, S; Can, G; Senel, S; Capar, S; Dalkilic, HE; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanc, N; Birlik, M; Solmaz, D; Cefle, A; Goker, B; Yolbas, S; Krough, NS; Yilmaz, N; Erten, S; Bes, C; Soysal, O; Ozturk, MA; Haznedaroglu, S; Yavuz, S; Direskeneli, H; Onen, F; Sari, I
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    Efficacy and Safety of CT-P13 as First- and Second-Line Treatment in Patients with Ankylosing Spondylitis
    Uslu, S; Gülle, S; Sen, G; Capar, S; Senel, S; Dalkilic, E; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanc, N; Birlik, M; Solmaz, D; Cefle, A; Goker, B; Direskeneli, H; Yolbas, S; Krogh, NS; Yilmaz, N; Erten, S; Bes, C; Gündüz, OS; Oztürk, MA; Haznedaroglu, S; Yavuz, S; Onen, F; Sari, I
    Background/Objectives: CT-P13 is a biosimilar version of infliximab, a monoclonal antibody. In individuals with ankylosing spondylitis (AS), CT-P13 has been shown to be effective and to have a well-tolerated safety profile. The aim of this study was to evaluate the long-term drug persistence, safety, and efficacy of infliximab biosimilar CT-P13 in patients with AS undergoing first-line (1st-line) and later (>= 2nd-line) treatment in clinical practice. Methods: We performed an observational cohort study that included AS patients based on the biological drug database in the TURKBIO Registry between 2014 and 2021. The patients were divided into two groups: those receiving CT-P13 as first-line treatment or as a switch (>= 2nd-line) from another TNF inhibitor (TNFi). Standard disease activity metrics were used to assess the effectiveness of CT-P13, and drug retention rates were investigated. Results: There were 179 AS patients using CT-P13 (47.4% male, mean age: 42.9 +/- 11.3 years). Of these patients, 123 (68.7%) were receiving CT-P13 as a first-line treatment. The mean length of treatment was 3.5 years. CT-P13 drug retention rates in the general patient population were 58.6% and 48.2% in the first-line and >= second-line treatment, respectively, after 3 years of follow-up. The most common reason for CT-P13 treatment discontinuation was lack of efficacy. The first-line CT-P13 group had statistically substantially higher ASAS20/40 response rates at three and six months. Nonetheless, both groups' response rates at one year were comparable. Conclusions: In this real-world data analysis, AS patients who were TNFi na & iuml;ve (1st-line) and subsequently treated (>= 2nd-line) with CT-P13 showed encouraging drug retention rates with acceptable long-term effectiveness and safety.
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    Efficacy and Safety of Secukinumab in the Treatment of Axial Spondyloarthritis: Real-Life Data from TURKBIO Cohort
    Gulle, S; Karakas, A; Can, G; Senel, S; Capar, S; Dalkilic, HE; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanc, N; Birlik, M; Solmaz, D; Cefle, A; Goker, B; Yolbas, S; Krough, NS; Yilmaz, N; Erten, S; Bes, C; Soysal, O; Ozturk, MA; Haznedaroglu, S; Yavuz, S; Direskeneli, H; Onen, F; Sari, I
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    A real-life analysis of patients with rheumatologic diseases on biological treatments: Data from TURKBIO Registry
    Önen, F; Can, G; Çapar, S; Dalkiliç, E; Pehlivan, Y; Senel, S; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanç, N; Sari, I; Birlik, M; Solmaz, D; Cefle, A; Öztürk, MA; Yolbas, S; Krogh, NS; Yilmaz, N; Erten, S; Bes, C; Gündüz, ÖS; Göker, B; Haznedaroglu, S; Yavuz, S; Çetin, GY; Yildiz, F; Direskeneli, H; Akkoç, N
    Objective: TURKBIO registry, established in 2011, is the first nationwide biological database in Turkey. This study aimed to provide an overview of TURKBIO data collected by June 2018. Methods: The registry included adult patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), nonradiographic axial spondyloarthritis (nr-AxSpA), and psoriatic arthritis (PsA). Demographic and clinical features, disease activity markers, and other follow-up parameters, current and previous treatments, and adverse events were registered electronically at each visit using open-source software. The registration of patient-reported outcome measures was carried out electronically by the patients using touch screens. Results: TURKBIO registry included a total of 41,145 treatment series with biologicals. There were 2,588 patients with axSpA (2,459 AS and 129 nr-axSpA), 2,036 with RA, and 428 with PsA. The total number of patients, including those with other diagnoses, was 5,718. In the follow-up period, the number of patients and also visits steadily increased by years. The yearly mean number of visits per patient was found to be 2.3. Significant improvements in disease activity and health assessment parameters were observed following the biological treatments. Biologics were often given in combination with a conventional synthetic disease-modifying antirheumatic drug in patients with RA. Infections were the most commonly seen adverse events, followed by allergic reactions. Tuberculosis was observed in 12 patients, malignancy in 18, and treatment-related mortality in 31. Conclusion: TURKBIO provided a valuable real-life experience with the use of biologics in rheumatic diseases in Turkey.
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    DO COMORBIDITIES IMPACT PERSISTENCE OF FIRST TUMOR NECROSIS FACTOR INHIBITOR TREATMENT IN RHEUMATOID ARTHRITIS? DATA FROM TURKBIO
    Inel, TY; Kocaer, SB; Erez, Y; Gulle, S; Karakas, A; Avsar, AK; Uslu, S; Can, G; Sari, I; Birlik, M; Dalkiliç, E; Pehlivan, Y; Akar, S; Goker, B; Cetin, GY; Haznedaroglu, S; Yavuz, S; Pirildar, T; Direskeneli, H; Akkoc, N; Onen, F
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    Unusual torture methods and mass murders applied by a terror organization
    Asirdizer, M; Yavuz, S; Sari, H; Canturk, G; Yorulmaz, C
    This study aims at describing autopsy findings of 19 victims killed by various torture methods applied by a terror organization after they had been kidnapped by this organization, as well as the unusual and unique binding style applied during these killings. The present study also aims at describing the unusual killing method of binding for literature and discussing international descriptions of torture.
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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.