Browsing by Author "Cengiz, Nurcan"

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The African Variant of BKV in A Turkish Renal Transplant Patient
(2014) Colakoglu, Sule; Dursun, Hasan; Cengiz, Nurcan; Bulat, Meryem Cosar; Noyan, Aytul; https://orcid.org/0000-0002-8817-494X; 24726687; AAB-7105-2020; GPX-7059-2022; AAD-5713-2021
In renal transplant recipients, BK polyomavirus (BKV) is linked to nephropathy. BK virus genotypes have a strong geographic component. This paper presents the African variant of BKV in a Turkish renal transplant patient, which is a rare cause of infection in the Northern Hemisphere and, to our knowledge, the first case from Turkey. (C) 2014 Elsevier Inc. All rights reserved.
Can We Differentiate Pyelonephritis and Cystitis without 99mTc-Dimercaptosuccinic Acid Scan in Children?
(2015) Kilicaslan, Buket; Noyan, Aytul; Cengiz, Nurcan; Sariturk, Cagla; Parmaksiz, Gonul; Baskin, Esra
Purpose: Urinary tract infection is one of the most common infections in childhood. Because of the long term sequelae, differentiation of pyelonephritis from cystitis is important. The aim of this study is to determine the value of biomarkers such as C-reactive protein and procalcitonin and whether preferred to predict pyelonephritis in children without 99mTc-Dimercaptosuccinic Acid scan. Material and Methods: Fifty children aged 3 months to 16 years with a first urinary tract infection were included in this retrospective observational study. The medians, sensitivity, specificity, and cut-off values of serum C - reactive protein and procalcitonin to predict pyelonephritis were determined. Results: Thirty-two (64%) patients were diagnosed with pyelonephritis and 18 (36%) were diagnosed with cystitis. The cut-off value for C - reactive protein was 34 mg/L to predict pyelonephritis, with 69% sensitivity and 61% specificity. The cut-off value for procalcitonin was 0.23 ng/mL to predict pyehlonephritis, with 69% sensitivity and 66% specificity. In combination, these biomarkers were 63% sensitive and 78% specific to predict pyelonephritis. Conclusion: Using a combination of procalcitonin and C-Reactive Protein is preferred to predict pyelonephritis in children, instead of the 99mTc-Dimercaptosuccinic Acid scan. Because of its disadvantages, the 99mTc-Dimercaptosuccinic Acid scan should be avoided in children.
Genotypic and Phenotypic Features of the Cystinosis Patients from the South Eastern Part of Turkey
(2016) Onenli-Mungan, Neslihan; Kor, Deniz; Karabay-Bayazit, Aysun; Cengiz, Nurcan; Yavuz, Sevgi; Noyan, Aytul; Ceylaner, Gulay; Seker Yilmaz, Berna; Topaloglu, Ali Kemal; Yuksel, Bilgin; Anarat, Ali; 28276207; GPX-7059-2022
We have conducted this study for the purposes of demonstrating the spectrum of mutations and of identifying their effects on the phenotype, with a particular focus on the clinical course, prognosis and response to treatment. A total of 25 patients from 20 families, who have been treated and followed up after being diagnosed with cystinosis. Nine patients were identified with mutations of homozygous c. 451A>G, 7 patients with homozygous c. 681G>A, 6 patients with homozygous c. 834_842del, 2 patients with homozygous c. 18_21delGACT and 1 patient with compound heterozygous for c. 451A>G/c. 1015G>A. The c. 834_842del mutation identified in six patients from four families has not been previously identified. Progression to renal failure occurred earlier in the patients identified with the new mutation, despite treatment. Larger patient series are required to demonstrate the genotypic properties of the patients with cystinosis and their relationship with the clinical course.
Obez çocuklarda alt üriner sistem disfonksiyonunun değerlendirilmesi
(Başkent Üniversitesi Tıp Fakültesi, 2015) Yalman Özbey, Işık; Cengiz, Nurcan
Obezite günümüzün en sık hastalıkları listesinde giderek üst sıralara yükselmekte ve Dünya Sağlık Örgütü (WHO) tarafından çocukluk çağının en sık görülen kronik hastalıkları arasında yer almaktadır. Yarattığı sonuçlar nedeniyle ileri yaşlar için ciddi bir sağlık sorunu olan obezite erişkinler kadar çocukları da tehdit etmektedir. Obezitenin erken yaşta önlenmesi erişkin dönemde gelişebilecek komplikasyonlardan korunma açısından önemlidir. Alt üriner sistem disfonksiyonu çocukluk çağında en sık görülen işeme problemidir. İşeme disfonksiyonu üriner sistemde belirgin yapısal hasar oluşturma riski nedeniyle önemlidir. Alt üriner sistem disfonksiyonu ve çocukluk çağı obezitesi arasındaki ilişkiyi inceleyen çok net çalışmalar bulunmamaktadır. Bu çalışmada obez çocuklarda üroflovmetre verileri ve disfonksiyonel işeme semptom skoru birlikte değerlendirilerek alt üriner sistem disfonksiyonu sıklığı araştırılmıştır. 5-18 yaş arası yaş-cinsiyete göre VKİ 85-95 persentil arası olan 52 fazla kilolu çocuk, VKİ 95 persentil üzeri olan 151 obez çocuk ve VKİ normal sınırlarda olan 118 çocuk ise kontrol grubu olarak çalışmaya dahil edilmiştir. Çalışmaya dahil edilen hastalara disfonksiyonel işeme semptom skorlaması (DİSS) ve üroflowmetri yapıldı. Tüm üroflovmetri eğrileri normal (çan) veya anormal (kule, „staccato‟ , „interrupted‟, plato) olarak sınıflandı. Hastalar üroflovmetrideki işeme hacmine göre mesane volümü açısından değerlendirildi. Üroflowmetri işeme paterni değerlendirildiğinde obez ve fazla kilolu grupta kontrol grubuna göre anormal işeme paternleri daha sık (sırasıyla %51, % 44,2 ve % 23,7) saptanmıştır. Kontrol grubunun %33,9‟unda, fazla kilolu grubun %34,6‟sında ve obez grubun %53,2‟sinde konstipasyon varlığı saptandı. Disfonksiyonel işeme semptom skoru için kesim değeri %71,9 sensitivite, %67,8 spesifite ile 7,5 olduğu saptandı. Bu çalışmada obez çocuklarda üroflowmetri verileri ve disfonksiyonel işeme semptom skorlaması bilgileri kombine edilmiştir. Alt üriner sistem disfonksiyonu başlangıç değerlendirmesi her zaman semptom skoru ve klinik bulgulara göre yapılmalıdır. Semptom skoru ve üroflowmetri sonuçlarına göre alt üriner sistem disfonksiyonu olduğu düşünülen ve üroterapiye cevap vermeyen hastalara ürodinamik çalışma gibi ileri incelemeler yapılmalıdır. Obesity goes to top of today‟s most common diseases list and is among the most common chronic diseases in childhood defined by World Health Organization (WHO). Obesity constitutes a serious health problem at later ages due to its consequences, threatening children as well as adults. Preventing obesity at early ages is important to avoid the complications that may develop during adulthood. Lower urinary tract dysfunction is the most common voiding problem in childhood. Voiding dysfunction is important as it may cause significant structural damage on urinary system. There are no precise studies on the relationship between the lower urinary tract dysfunction and obesity in childhood. In this study, lower urinary tract dysfunction frequency in obese children has been shown by evaluating uroflowmetry data together with dysfunctional voiding symptom score. 52 overweight children aged 5-18 years with a BMI percentile range between 85-95 according to age-gender, 151 obese children with BMI above 95 percentile and 118 children with BMI within the normal limits (control group) have been included in the study. Dysfunctional voiding symptom scoring (DVSS) and uroflowmetry were performed in all patients. All uroflowmetry curves were classified as normal (bell-shaped) or abnormal (tower-shaped, „staccato‟ , „interrupted‟, plateau). Patients were evaluated in terms of urinary bladder volume according to the voiding volume in uroflowmetry. When the uroflowmetry voiding patterns were evaluated, abnormal voiding patterns have been found to exist more often in obese and overweight group compared to the control group (51%, 44,2% and 23,7%, respectively). Constipation was detected in 33,9% of the control group, 34,6% of the overweight group and 53,2% of the obese group. The cut-off value for dysfunctional voiding symptom score was determined as 7,5 with 71,9% sensitivity and 67,8% specifity. In this study, uroflowmetry data and dysfunctional voiding symptom scoring data of obese children were combined. Baseline evaluation of lower urinary tract dysfunction should always be performed according to the symptom score and clinical findings. Further examinations such as urodynamic study should be performed in patients with clinical suspicion of lower urinary tract dysfunction according to the symptom score and uroflowmetry results and who fail to respond to urotheraphy.
Pediatric Renal Transplantation: A Single Center Experience
(2015) Dursun, Hasan; Cengiz, Nurcan; Noyan, Aytul; Caliskan, Kenal; Basturk, Bilkay; Yildirim, Sedat; Moray, Gokhan; Baskin, Esra; Haberal, Mehmet; 0000-0002-5735-4315; 0000-0002-8817-494X; 0000-0003-2498-7287; 0000-0002-3462-7632; 0000-0003-4361-8508; 0000-0002-8784-1974; AAF-4610-2019; AAB-7105-2020; AAE-1041-2021; AAJ-8097-2021; AAD-5713-2021; B-5785-2018; AAD-6918-2021
Potentially Reversible Encephalopathy in Children with Chronic Renal Failure
(2015) Dursun, Hasan; Cengiz, Nurcan; Saygi, Semra; Alkan, Ozlem; Savas, Tulin; Noyan, Aytul; 0000-0002-8817-494X; 0000-0001-7526-3460; 0000-0002-8522-5078; AAB-7105-2020; AAM-4169-2021; AAB-1203-2021; AAD-5713-2021
Prevalence of Hypertension in Children and Adolescents with Unclassified Headache
(2015) Dursun, Hasan; Saygi, Semra; Cengiz, Nurcan; Savas, Tulin; Erol, Ilknur; Noyan, Aytul; 0000-0002-8817-494X; 0000-0002-3530-0463; 0000-0002-8522-5078; AAB-7105-2020; AAK-4825-2021; AAD-5713-2021; AAB-1203-2021
Role of New Biomarkers for Predicting Renal Scarring in Vesicoureteral Reflux: NGAL, KIM-1, And L-FABP
(2016) Parmaksiz, Gonul; Noyan, Aytul; Dursun, Hasan; Ince, Emine; Anarat, Ruksan; Cengiz, Nurcan; https://orcid.org/0000-0003-2373-1837; 26324091; AAM-2935-2021; AAD-5713-2021; AAW-8783-2020
Reflux nephropathy is the most serious complication of vesicoureteral reflux (VUR). The aim of this study was to assess the role of urinary levels of neutrophil-gelatinase-associated lipocalin (NGAL),kidney injury molecule-1 (KIM-1), and liver-type fatty-acid-binding protein (L-FABP) in the early diagnosis of reflux nephropathy in patients with VUR. This study assessed 123 patients with primary VUR and 30 healthy children as a control group. The children were divided into five groups: Group A, patients with VUR and renal parenchymal scarring (RPS); Group B, patients with VUR and without RPS; Group C, patients with RPS and resolved VUR; Group D, patients with resolved VUR and without RPS; Group E, healthy reference group. Median urinary NGAL (uNGAL)/Creatinine (Cr) was significantly higher in patients with than those without RPS and the control group (p = 0.0001). Median uKIM-1/Cr was similar in all groups (p = 0.417). Median uL-FABP/Cr was significantly higher in patients with RPS than in the reference group (p < 0.05). Urinary NGAL levels may be used as a noninvasive diagnostic marker for predicting renal scarring in reflux nephropathy.
Urinary NGAL, KIM-1 and L-FABP Concentrations in Antenatal Hydronephrosis
(2015) Noyan, Aytul; Parmaksiz, Gonul; Dursun, Hasan; Ezer, Semire Serin; Anarat, Ruksan; Cengiz, Nurcan; 0000-0002-8817-494X; 0000-0003-2373-1837; 0000-0002-9597-3264; 26096437; AAJ-9529-2021; AAB-7105-2020; AAD-5713-2021; AAW-8783-2020; GPX-7059-2022; AAM-2935-2021
The clinical tests currently in use for obstructive nephropathy (such as renal ultrasonography, differential radionuclide renal scans and urinary creatinine concentration data) are not efficient predictors of the subsequent clinical course. Novel and simple biomarkers are required which, if proven, could be clinically beneficial in determining if a patient is eligible for surgery or reno-protective therapy. More recently, the interest of clinicians has focused on the potential of urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary kidney injury molecule-1 (uKIM-1) and urinary liver-type fatty acid-binding proteins (uL-FABP) as biomarkers for renal function in children with hydronephrosis (HN). Objective The purpose of this study was to investigate possible clinical applications of uNGAL, uKIM-1 and uL-FABP as beneficial non-invasive biomarkers to determine whether or not surgical intervention is required in children with HN. Study design Renal ultrasonography and radionuclide renal scans were used as diagnostic tools to detect HN. Patients were divided into two groups based on the anteroposterior diameter of their renal pelvis and the presence of dysfunction. Group 1 included 26 children with severe HN (with dysfunction), and group 2 consisted of 36 children with mild HN (without dysfunction). Urine samples were collected from 62 children with HN and 20 healthy children. Results Hydronephrosis was more common in males than in females, with a male to female ratio of 9: 1 in the study sample. The incidence of left kidney involvement (32 patients) was slightly higher than right kidney involvement (28 patients). Compared with controls and group 2, the ratio of uNGAL to creatinine was significantly higher in group 1 (p < 0.05). The biomarker uNGAL/Cr exhibited fairly good diagnostic accuracy, with an area under the curve of 0.68 [95% confidence interval 0.6-0.7] and an optimal cut-off value of 0.16 ng/mg Cr (sensitivity 58%, specificity 75%) (p < 0.05). There was a positive correlation between the uNGAL/Cr ratio and the uKIM-1/Cr ratio (r = 0.582, p < 0.05) and uL-FABP/Cr ratio (r = 0675, p < 0.05) in group 1. Discussion The results clearly demonstrated that children with hydronephrosis and dysfunction had significantly increased uNGAL, and uNGAL/Cr concentrations. However, uKIM-1, uKIM-1/Cr, uL-FABP and uL-FABP/Cr concentrations were not significantly different when compared with controls. These results support the use of uNGAL concentrations as an early marker for renal dysfunction in HN. Conclusions The study clearly demonstrated that pediatric patients with hydronephrosis and dysfunction had significantly higher uNGAL to creatinine concentrations as compared with controls.
Urinary Ngal, Kim-1 and L-fabp Levels in Antenatal Hydronephrosis
(2014) Dursun, Hasan; Noyan, Aytul; Parmaksiz, Gonul; Ezer, Semire Serin; Anarat, Ruksan; Cengiz, Nurcan; https://orcid.org/0000-0002-8817-494X; https://orcid.org/0000-0003-2373-1837; AAW-8783-2020; AAD-5713-2021; AAM-2935-2021; AAJ-9529-2021
Urinary Ngal, Kim-1 and L-fabp Levels in Patients with Vesicoureteral Reflux
(2014) Parmaksiz, Gonul; Noyan, Aytul; Dursun, Hasan; Ince, Emine; Anarat, Ruksan; Cengiz, Nurcan; https://orcid.org/0000-0003-2373-1837; https://orcid.org/0000-0002-8817-494X; AAM-2935-2021; AAD-5713-2021; AAB-7105-2020
Value of Sonographic Anterior-Posterior Renal Pelvis Measurements Before and After Voiding for Predicting Vesicoureteral Reflux in Children
(2015) Demir, Senay; Tokmak, Naime; Cengiz, Nurcan; Noyan, Aytul; 0000-0002-4209-9075; 25545034; GPX-7059-2022; AAD-5713-2021; AAK-9310-2021
PurposeVoiding cystourethrography (VCUG) is the gold standard for diagnosing vesicoureteral reflux (VUR), but it is important to minimize the use of VCUG because of the urinary catheterization and radiation exposure required. Ultrasound (US) observations suggest that pelvicalyceal dilatation varies according to the degree of bladder fullness in children with urinary tract infection. The aim of this study was to assess whether anterior-posterior (AP) measurements of the renal pelvis on US before and after voiding can be used as a screening tool while predicting the presence of VUR in children. MethodsThe subjects were toilet-trained children older than 4 years who required VCUG. Two groups were established based on the VCUG results: a VUR group of 40 kidney units (each unit defined as calyces and ureter) that exhibited different severities of reflux, and a control group of 68 kidney units unaffected by VUR. Prior to VCUG, US AP measurements of the renal pelvis of each kidney unit were recorded when the urinary bladder was full and again after bladder emptying. The change in AP measurement from before to after voiding was compared between the two groups. ResultsThe mean change in AP measurements from before to after voiding in the VUR group was significantly greater than that in the control group (p=0.003). ConclusionsComparing US AP measurements of the renal pelvis before and after voiding is useful for identifying children who are suspected to have VUR and thus require immediate VCUG. (c) 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43:490-494 2015