Browsing by Author "Cevik, Halime"

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Aortic flow propagation velocity, epicardial fat thickness, and osteoprotegerin level to predict subclinical atherosclerosis in patients with nonalcoholic fatty liver disease
(2016) Gulmez, Oyku; Oguz, Didem; Unal, Hakan Umit; Eroglu, Hacer; Cevik, Halime; Altun, Armagan; 0000-0002-9429-5430; 0000-0002-3233-8263; 27025201; ABC-7134-2021; ABB-5844-2020
Objective: Nonalcoholic fatty liver disease is the most common cause of liver dysfunction in Western countries and an independent risk factor for atherosclerotic heart disease. Appropriate noninvasive parameters are lacking for optimal risk stratification of cardiovascular disease in these patients. We evaluated several recently discovered noninvasive parameters for atherosclerosis in patients with nonalcoholic fatty liver disease: epicardial fat thickness, aortic flow propagation velocity, and osteoprotegerin level. Methods: Forty-one patients (27 men and 14 women; mean age, 37.9 +/- 8.9 years) with nonalcoholic fatty liver disease and 37 control subjects (17 men and 20 women; mean age, 34.5 +/- 8.6 years) were enrolled in this observational case-control study. Patients with nonalcoholic fatty liver disease diagnosed at a gastroenterology outpatient clinic were included. Patients with cardiac pathology other than hypertension were excluded. Epicardial fat thickness and aortic flow propagation velocity were measured by echocardiography. The serum concentration of osteoprotegerin was measured using a commercial enzyme-linked immunosorbent assay kit. Results: Nonalcoholic fatty liver disease patients exhibited a significantly lower aortic flow propagation velocity (155.17 +/- 30.00 vs. 179.00 +/- 18.14 cm/s, p=0.000) and significantly higher epicardial fat thickness (0.51 +/- 0.25 vs. 0.29 +/- 0.09 cm, p=0.000) than control subjects. Osteoprotegerin levels were higher, but not significant, in patients with nonalcoholic fatty liver disease (28.0 +/- 13.0 vs. 25.2 +/- 10.8 pg/mL, p=0.244). Binary logistic regression analysis showed that aortic flow propagation velocity (OR, -0.973; 95% CI, 0.947-0.999) and waist circumference (OR, -1.191; 95% CI, 1.088-1.303) were independent predictors of nonalcoholic fatty liver disease. C Conclusion: In this study, epicardial fat thickness and osteoprotegerin level were higher and aortic flow propagation velocity was lower in patients with nonalcoholic fatty liver disease. Early detection of abnormal epicardial fat thickness and aortic flow propagation velocity may warrant a search for undetected cardiovascular disease in patients with nonalcoholic fatty liver disease.
Combined catheter thrombus fragmentation and percutaneous thrombectomy in a patient with massive pulmonary emboli and acute cerebral infarct
(2015) Ugurlu, Aylin Ozsancak; Cinar, Ozlem; Caymaz, Ismail; Cevik, Halime; Gumus, Burcak; 25550253
Diagnostic value of shear wave velocity in polycystic ovarian syndrome
(2021) Gursu, Turkan; Cevik, Halime; Desteli, Guldeniz Aksan; Yilmaz, Birnur; Bildacı, Tevfik Berk; Eraslan, Alper; 34970437
Aim: In polycystic ovarian syndrome, the ovaries become stiffer due to chronic anovulation. We aimed to compare tissue elasticity in terms of shear wave velocities measured using acoustic radiation force impulse imaging technique between the ovaries of polycystic ovarian syndrome women and non-polycystic ovarian syndrome women. Material and methods: The study was designed as a retrospective data analysis of women who underwent transvaginal ultrasound and acoustic radiation force impulse imaging in a university hospital between July 2014 and March 2015, for various reasons. There were 32 polycystic ovarian syndrome patients and 32 patients without a diagnosis of polycystic ovarian syndrome. Age, body mass index, fasting glucose levels, cycle day 3 follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, prolactin, antimullerian hormone levels, and menstrual patterns with clinical hyperandrogenism were evaluated. On the menstrual cycle days 2-4, by performing a transvaginal ultrasound scan, the ovarian volumes and antral follicle counts in both ovaries were recorded for each woman. The ultrasound system was converted into the elastography mode, and acoustic radiation force impulse imaging was performed. Shear wave velocity (m/sec) was measured at least 5 times for each ovary, and the mean value was calculated for each polycystic ovarian syndrome and non-polycystic ovarian syndrome woman. Results: Age, body mass index, fasting glucose levels, cycle day 3 follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, and prolactin levels were similar between the groups (p 0,05). Antimullerian hormone levels, antral follicle counts, and mean ovarian volumes were statistically different between the groups (p <0,05). Mean shear wave velocity values for both ovaries were 2.12 +/- 0.82 (0.78-4.9) m/sec in the polycystic ovarian syndrome group, and 1.18 +/- 0.41 (0.77-2.0) m/sec in the non-polycystic ovarian syndrome group, which was statistically significantly different (p = 0.016). Conclusion: In our study, we found significantly higher shear wave velocity levels in polycystic ovarian syndrome women than non-polycystic ovarian syndrome women, which indicates an impact of the condition on shear wave velocity. The increased acoustic frequencies cause a decreased response in time to transition, and motion becomes out of phase; in other words, scattered waves are faster in stiffer ovaries. Our results are thus compatible with the pathophysiology of the disease. Shear wave velocity is a beneficial tool for evaluating ovarian elasticity in polycystic ovarian syndrome patients in whom the levels are found to be significantly higher than non-polycystic ovarian syndrome women. In light of these findings, shear wave velocity is expected to be slower than polycystic ovarian syndrome levels in ovulatory women.
How much are the incidental abnormalities on brain MRI clinically significant in otolaryngology practice?
(2016) Koc, Ayca Ozbal; Ertugay, Cigdem Kalaycik; Cevik, Halime; Erbek, Selim Sermed
Objective: We aimed to investigate the frequency of incidental diagnosis of paranasal sinus and mastoid abnormalities on brain magnetic resonance imaging (MRI) and its correlation with symptoms of patients. Methods: We examined 100 patients who underwent brain MRI due to several different complaints other than sinusitis and mastoiditis. The patients who had any nasal or otologic pathology in otolaryngology examination were excluded from the study. Afterwards, a total of 65 patients were included into the study. The questionnaire consisted of otological symptoms and Sino-nasal Outcome Test (SNOT-20), Lund and Mackay scoring system for rhinosinusitis were filled by all patients immediately prior to imaging. The analysis of the MRI scan in terms of rhinosinusitis according to the Lund-Mackay radiological scoring and mastoiditis was performed by the same radiologist. Results: The mean age of 65 patients was 46.62 +/- 17.73 years. Eighteen (27.7%) of these were men and 47 (72.3%) were women. In 26 (40%) of 65 patients, MRI demonstrated mastoiditis. We could not find any statistically significant correlation between mastoiditis and upper respiratory tract infection (p=0.896). There was no statistically significant relationship between radiological scores and total sinus symptom scores (p=0.93). Additionally, we could not find any correlation between radiological scores and SNOT-20 (p=0.923). Conclusion: Our findings demonstrated that although some of these patients had various symptoms of sinus or mastoid diseases, these symptoms had no statistically significant correlation with the radiological diagnosis. In conclusion, radiologists should advise clinical correlation of their radiologic findings rather than reporting a clinical diagnosis such as sinusitis and mastoiditis.
Influence of Various Living Donor Kidney Measurements in Relation to Recipient Body Measurements on Posttransplant Allograft Functional Outcomes
(2018) Kulah, Eyup; Ozcelik, Umit; Isiklar, Iclal; Cevik, Halime; Bircan, Huseyin Yuce; Karakayali, Feza Y.; Haberal, Mehmet; https://orcid.org/0000-0001-6041-4254; https://orcid.org/0000-0003-1073-2494; https://orcid.org/0000-0002-1874-947X; https://orcid.org/0000-0002-3462-7632; 27356006; AAJ-5764-2021; AAG-8651-2021; R-6394-2019; AAB-3888-2021; AAJ-8097-2021
Objectives: Donor kidney measurements may affect outcomes of transplanted allografts. We tested allograft and recipient measurements on kidney allograft outcomes. In this study, we compared the effects of kidney allograft volumes, which were measured using computed tomographic angiography before transplant, and allograft weight, which was measured during surgery, in relation to the recipient's body weight and body mass index on kidney function at 6 and 12 months after transplant. Material and Methods: We included 74 patients (40 female and 34 male patients, mean age of 50.42 +/- 9.75 y) in this study. Results: Intraoperative allograft weight was 182.68 +/- 40.33 g (range, 104-266 g). The allograft volume measured using computed tomographic angiography scanning was 123.34 +/- 24.26 ml (range, 78-181 ml). The estimated glomerular filtration rates of the recipients at 6 and 12 months after transplant correlated negatively with age and recipient body mass index but correlated positively with allograft volume/recipient body weight, allograft volume/recipient body mass index, allograft weight, allograft weight/recipient body weight, and allograft weight/recipient body mass index values, as concluded by univariate analyses. From multivariate analyses, we found variables of interest presumed to significantly affect the 12-month estimated glomerular filtration rates, including recipient age, allograft volume/recipient body weight, allograft volume/recipient body mass index, allograft weight, allograft weight/recipient body weight, and allograft weight/recipient body mass index. Conclusions: Transplanted allograft and recipient body values may be used as predictors of estimated glomerular filtration rates 6 and 12 months after transplant.
Multiple Brain Abscesses Due to Phialemonium in a Renal Transplant Recipient: First Case Report in the Literature
(2015) Aydin, Mehtap; Ozcelik, Umit; Cevik, Halime; Cinar, Ozlem; Evren, Ebru; Demirag, Alp; 0000-0003-1073-2494; 0000-0003-4044-9366; 26640919; AAG-8651-2021; HLX-0937-2023; JAZ-1759-2023
Fungal brain abscesses are a rare but serious complication in transplant recipients. Phialemonium organisms are rare causes of invasive mold infections. Here, we present the first case of a renal transplant recipient with multiple brain abscesses caused by Phialemonium infection A. A 51-year-old female kidney transplant recipient was admitted with pneumonia of an unknown cause and treated with empiric intravenous antibiotics. Her treatment was uneventful, and she was discharged 1010 days later. After 5 days, she was readmitted with fever, cerebral palsy, and speech disorder. The patient had undergone living-donor renal transplant 7 months earlier. A cranial computed tomography and magnetic resonance imaging were performed for a possible cerebro vascular pathology. The magnetic resonance imaging scan showed multiple brain abscesses located at the left parietal, frontal and occipital lobes; right parietal and occipital lobes; right basal ganglia; and left cerebellum. The patient received meropenem, linezolid, sulfamethoxazole and trimethoprim, and AmBisome for probable pathogenic infection, and immunosuppressive agents dosage was reduced increasingly immuno suppressed. We identified Phialemonium in cerebrospinal fluid culture. The patient received voriconazole 200 mg twice daily. Lesions could not be drained due to lack of capsula formation. The patient died on the 30th day of antifungal therapy. Phialemonium organisms, although a rare cause of fungal infections, are associated with a high mortality rate in immunocompromised patients. To our knowledge, this is the first case report in the literature describing multiple brain abscesses due to Phialemonium in a transplant recipient. Clinicians recipient should be alert about these rare opportunistic fungi in the differential diagnosis of brain abscess, and bronchoscopy and broncho alveolar lavage are recommended for transplant patients when they are admitted with pneumonia exclude fungal infections.
Placental elasticity on patients with gestational diabetes: Single institution experience
(2017) Bildaci, Tevfik Berk; Cevik, Halime; Desteli, Guldeniz Aksan; Tavasli, Birnur; Ozdogan, Serdinc; 28539240
Background: Gestational diabetes is defined as glucose intolerance which is first recognized in pregnancy. Oral glucose tolerance test (OGTT) is the cornerstone in diagnosing gestational diabetes. Placental elasticity evaluation is relatively new concept and is principally used for research purposes. We aimed to find any relation between placental elasticity evaluation and patients of gestational diabetes diagnosed by 75 g OGTT. Methods: There were 91 patients took part in study, forming two groups as gestational diabetic patients (21 patients) and control group (70 patients). Elasticity of placenta was determined by acoustic radiation force impulse technology utilized by two blinded radiology specialists. Results: We were not able to find any correlation between 75 g OGTT values and placental elasticity measurements (p > .05). Also placental elasticity was not found to be significantly different in two groups (p > .05). Conclusion: Placental elasticity measurement on the 24th-28th weeks does not seem to be a marker for identification of gestational diabetes. Copyright (C) 2017, the Chinese Medical Association. Published by Elsevier Taiwan LLC.
Renal Stiffness on Patients with Gestational Diabetes
(2017) Yilmaz, Birnur; Cevik, Halime; Bildaci, Tevfik Berk; Ozdogan, Serdinc
Introduction: Gestational diabetes is defined as glucose intolerance first recognized in pregnancy. Oral glucose tolerance testing is the cornerstone in diagnosing gestational diabetes. In this study, we aimed to find a new method of diagnosis in addition to conventional diagnosed by 75 gr oral glucose tolerance testing. Material and methods: 121 pregnant woman were included part in this study, forming two groups as gestational diabetic patients (51 patients) and control group (70 pregnant woman). Both kidneys are evaluated with B Mode Ultrasound and Colour Doppler Ultrasound mode by measuring resistive index for depiction of other renal pathologies. Stiffness of renal tissue determined by Acoustic Radiation Force Impulse (ARFI) technology utilized by two blinded radiology specialists. Results: We were not able to find any correlation between gestational diabetes mellitus and resistivity index measurements (p > 0.05). But a correlation between second hour glucose levels in oral glucose tolerance test and bilateral renal stiffness was found (p < 0,05). Conclusion: ARFI ultrasound may be a non-invasive technique in determining the course of the disease.
Use of Biological Prosthesis in a Patient With Kidney and Pancreas Transplant and a Giant Incisional Hernia: Case Report
(2015) Ozcelik, Umit; Cevik, Halime; Bircan, Huseyin Yuce; Demirag, Alp; 0000-0003-1073-2494; 0000-0001-7276-3240; 25894161; AAG-8651-2021; R-6394-2019; JWP-7324-2024
Objectives: The use of synthetic mesh in transplant patients is controversial. Recent studies have shown that biological prostheses have a greater ability to integrate into tissues, resist bacterial colonization, and reduce cytotoxic or allergic reactions, and provide similar functional results, compared with synthetic prostheses. Biological prostheses do not require any reduction or discontinuation of immunosuppressive therapy. We present the case of a kidney and pancreas transplant recipient who had a giant incisional hernia that was treated successfully with a biological prosthesis. Case Report: A 40-year-old male kidney and pancreas transplant recipient was admitted to our hospital with a giant incisional hernia, 2 years after transplant. The defect on the abdominal wall was 40 x 30 cm. We used 2 biological prostheses (40 x 20 cm and 30 x 20 cm) to close the abdominal wall. The patient was discharged on postoperative day 5 without complications. An abdominal magnetic resonance imaging scan showed complete integrity of the biological prostheses at 1 year after surgery. Conclusions: Transplant recipients have higher risks with use of synthetic prostheses because of being immunosuppressed, compared with other patients. Recent studies show that biological prostheses provided similar functional results without complications compared with synthetic prostheses. These prostheses are versatile and do not require any changes in immunosuppressive therapy. Therefore, they seem to be a better option than synthetic prostheses. In our opinion, biological prostheses are more safe, effective, and reliable than synthetic prostheses, especially for large incisional hernias in transplant recipients. We believe that further larger studies can support our opinion.
Value of in Vitro Acoustic Radiation Force Impulse Application on Uterine Adenomyosis
(2018) Bildaci, Tevfik Berk; Cevik, Halime; Yilmaz, Birnur; Desteli, Guldeniz Aksan; 10.1007/s10396-017-0845-y
Adenomyosis is the presence of endometrial glandular and stromal tissue in the myometrium. This phenomenon can be the cause of excessive bleeding and menstrual pain in premenopausal women. Diagnosis of adenomyosis may present difficulty with conventional methods such as ultrasound and magnetic resonance imaging. Frequently, diagnosis is accomplished retrospectively based on the hysterectomy specimen. This is a prospective case control study done in vitro on 90 patients' hysterectomy specimens. Acoustic radiation force impulse (ARFI) and color elastography were used to determine the elasticity of hysterectomy specimens of patients undergoing indicated surgeries. Based on histopathological examinations, two groups were formed: a study group (n = 28-with adenomyosis) and a control group (n = 62-without adenomyosis). Elasticity measurements of tissue with adenomyosis were observed to be significantly higher than measurements of normal myometrial tissue (p < 0.01). Uterine fibroids were found to have higher values on ARFI study compared to normal myometrial tissues (p < 0.01). The findings lead to the conclusion that adenomyosis tissue is significantly softer than the normal myometrium. ARFI was found to be beneficial in differentiating myometrial tissue with adenomyosis from normal myometrial tissue. It was found to be feasible and beneficial to implement ARFI in daily gynecology practice for diagnosis of adenomyosis.