Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

Browse

Filters

2014 - 2019112020 - 202310

Settings

Author: search.filters.author.Uslu, Nihalsearch.filters.applied.f.publicationcategory: search.filters.publicationcategory.Makale - Uluslararası Hakemli Dergi

Search Results

Now showing 1 - 10 of 21
  • No Thumbnail Available
    Item
    Neuroblastoma Accompanied by Hyperaldosteronism
    (2014) Gulleroglu, Kaan; Bayrakci, Umut; Kinik, Sibel Tulgar; Uslu, Nihal; Atilgan, Alev O. K.; Sarialioglu, Faik; Baskin, Esra; https://orcid.org/0000-0003-1434-3824; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-8257-810X; https://orcid.org/0000-0003-4361-8508; 25340174; AAJ-8833-2021; ABC-5258-2020; AAK-3333-2021; AAL-7766-2021; B-5785-2018
    Background: Tumors known derived from kidneys which take place in secondary hyperaldosteronism etiology are juxtaglomerular cell tumor and Wilms' tumor. Neuroblastoma presenting with hyperaldosteronism is rare. Case: A 15-month-old girl who had been having diarrhea and fever for 2 weeks presented with a 3 day history of bilious vomiting, metabolic acidosis and severe hypokalemia. She was referred to our hospital with the pre-diagnosis of unknown manifest hypertension etiology, diarrhea, and paralytic ileus after having therapy-resistant hypokalemia and severe resistant acidosis. On her examination after being admitted to our clinic, she was weak, unwell and lethargic with a blood pressure of 140/93 mmHg. Due to the hypertension and severe hypokalemia, the patient was considered to be hyperaldosteronism. Serum aldosterone level, plasma renin activity and cortisol level were elevated. Radiologic findings were compatible with neuroblastoma. The patient underwent an abdominal surgery and the mass excision. The histopathological examination was proved neuroblastoma. Conclusion: Hyperaldosteronism can be presented by unexpected atypical forms as in our patient.
  • No Thumbnail Available
    Item
    Interobserver and Intermethod Variability in Data Interpretation of Breast Strain Elastography in Suspicious Breast Lesions
    (2021) Turnaoglu, Hale; Haberal, Kemal Murat; Arslan, Serdar; Yavuz Colak, Meric; Ulu Ozturk, Funda; Uslu, Nihal; https://orcid.org/0000-0002-0781-0036; https://orcid.org/0000-0002-8211-4065; https://orcid.org/0000-0001-7984-4326; https://orcid.org/0000-0002-0294-6874; https://orcid.org/0000-0003-2782-2824; 32950046; AAK-8242-2021; R-9398-2019; AAA-4360-2021; JCP-5266-2023
    Background/aim: Strain elastography has the disadvantage of being operator-dependent. Interobserver variability is observed during image acquisition and interpretation. This study aimed to analyze the interobserver and intermethod variability of strain elastography in image interpretation and evaluate the diagnostic performance combining elasticity score and strain ratio with ultrasonography. Materials and methods: A retrospective study was conducted on 70 breast lesions evaluated with B-mode ultrasonography and strain elastography. B-mode ultrasonography findings, elasticity scores, and strain ratio values were evaluated using static images by two radiologists. BI-RADS assessment of the lesions and the decision of both observers as to whether the biopsy was required using B-mode ultrasonography, and the combined ultrasonography+elasticity score, and the combined ultrasonography+elasticity score+strain ratio were compared with the histopathological results. Also, the interobserver agreement was analyzed for all the combinations. Results: There was very good agreement (weighted kappa = 0.865) between the observers for the elasticity scores. Very good agreement was observed between the observers for BI-RADS assessments using the combined ultrasonography+elasticity score and the combined ultrasonography+elasticity score+strain ratio (weighted kappa = 0.848, and 0.902, respectively). Area under the curve of B-mode ultrasonography, the combined B-mode ultrasonography+elasticity score, and the combined B-mode ultrasonography+elasticity score+strain ratio, were calculated as 0.859, 0.866, and 0.916 for observer 1, and 0.851, 0.829, and 0.916 for observer 2, respectively. There were no statistically significant differences between the observers' diagnostic performances in any of the combinations (P = 0.703, 0.067, and 0.972, respectively). Conclusion: In the evaluation and further assessment of breast lesions, semiquantitative strain ratio calculation may help improve diagnostic accuracy by reducing interpretational variety, when used together with B-mode ultrasonography and elasticity scoring, especially for inexperienced individuals.
  • No Thumbnail Available
    Item
    Comparison of Clinical Features and Laboratory Findings of Coronavirus Disease 2019 and Influenza A and B Infections in Children: A Single-Center Study
    (2021) Siddiqui, Meraj; Gultekingil, Ayse; Bakirci, Oguz; Uslu, Nihal; Baskin, Esra; https://orcid.org/0000-0002-5739-6590; https://orcid.org/0000-0001-7955-5735; 34015895; ABF-7609-2022; AAR-9945-2020
    Background: As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. Purpose: This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. Methods: This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. Results: COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P=0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). Conclusion: In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.
  • No Thumbnail Available
    Item
    Doppler Ultrasonography Findings During Recovery Period of Transplanted Kidney After Infarction and Necrosis Due to Renal Vein Thrombosis: A Case Report
    (2017) Ozturk, Funda Ulu; Uslu, Nihal; Akcay, Eda Yilmaz; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-6733-8669; 0000-0001-6831-9585; 28260477; AAJ-8097-2021; ABC-5258-2020; AAK-1960-2021
    A 47-year-old male patient underwent living-related renal transplant. On day 3 posttransplant, without evidence of associated clinical symptoms, the patient's serum creatinine levels had increased. The patient was given immunosuppressive medication, and a follow-up Doppler ultrasonography revealed hypoechoic areas in the inferior pole of the renal parenchyma. Eventually, on day 25, there was no perfusion in the superior and inferior poles of the transplanted kidney. No venous flow was shown in the middle segment, and only arterial vascularization with a high resistive index and negative diastolic phase was observed. Renal biopsy showed acute humoral rejection. This was interpreted as venous thrombosis secondary to acute humoral rejection. Tissue plasminogen activator infusion, plasmapheresis, and hemodialysis were administered. After 1.5 months, arterial flow returned to its normal pattern and the renal allograft recovered by gaining back its full vascularity at the end of month 8.
  • No Thumbnail Available
    Item
    Ultrasonography Findings of Acute Tubulointerstitial Nephritis and Multiple Abscesses Following Renal Transplant: A Case Report
    (2017) Tezcan, Sehnaz; Uslu, Nihal; Soy, Ebru H. Ayvazoglu; Haberal, Mehmet; https://orcid.org/0000-0001-7204-3008; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3462-7632; 28260478; ABC-5258-2020; AAC-5566-2019; AAJ-8097-2021
    Urinary tract infection is the most common complication after kidney transplant that can cause graft loss. An early diagnosis of urinary infections decreases morbidity and mortality. Besides clinical and laboratory examinations, ultrasonography is considered as the primary imaging modality for the diagnosis of urinary tract infections. Here, we report a 53-year-old woman who presented with fever and pain at surgical site. Ultrasonography examination showed multiple, ill-defined or irregularly margined hypoechoic areas within the cortex. Ultrasonography-guided percutaneous renal biopsy was performed. Histopathologic findings were compatible with acute tubulointerstitial nephritis and multiple abscesses. Ultrasonography is the most widely applied imaging modality for diagnoses of complications after renal transplant. Although ultrasonography findings of infections are generally nonspecific, it still plays an important role in the diagnosis of urinary infections after renal transplant.
  • No Thumbnail Available
    Item
    Can Strain Elastography Combined with Ultrasound Breast Imaging Reporting and Data System Be A More Effective Method in The Differentiation of Benign and Malignant Breast Lesions?
    (2017) Arslan, Serdar; Uslu, Nihal; Ozturk, Funda Ulu; Akcay, Eda Yilmaz; Tezcaner, Tugan; Agildere, Ahmet Muhtesem; https://orcid.org/0000-0001-7984-4326; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0002-3641-8674; https://orcid.org/0000-0003-4223-7017; 28154989; AAH-9796-2019; ABC-5258-2020; AAK-1960-2021; AAD-9865-2021; AAB-5802-2020
    To investigate whether a novel method that combines breast imaging reporting and data system (BI-RADS) with strain elastography contributes to diagnostic performance in differentiation of malignant and benign breast lesions. In 81 patients, 81 breast lesions were prospectively investigated. Breast lesions were separately evaluated with ultrasonography and strain elastography. While evaluations with ultrasonography were based on 2003 BI-RADS-US, strain elastography evaluations were based on a 5-point scale and strain ratio. Diagnostic performances of ultrasonography, strain elastography, and the combined method were compared. Among 81 lesions, 43 (53.1%) were benign and 38 (46.9%) were malignant. When a cutoff point of category 3 was used, sensitivity, specificity, positive and negative predictive values, and accuracy for BI-RADS were 100, 11.6, 50, 100, and 53%, respectively. When BI-RADS and strain ratio were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 89.5, 93, 91.9, 90.9, and 91.3%, respectively. When BI-RADS and elastography scores were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 86.8, 97.7, 97.1, 89.4, and 92.5%, respectively. The combination of strain elastography and BI-RADS was found to have better diagnostic performances to diagnose breast lesions than BI-RADS alone.
  • No Thumbnail Available
    Item
    The Predictive Value of Resistive Index Obtained by Doppler Ultrasonography Early After Renal Transplantation on Long-Term Allograft Function
    (2017) Melek, Ergin; Baskin, Esra; Gulleroglu, Kaan; Uslu, Nihal; Kirnap, Mahir; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-4361-8508; https://orcid.org/0000-0003-1434-3824; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 27900821; B-5785-2018; F-3294-2013; ABC-5258-2020; AAH-9198-2019; AAE-1041-2021; AAJ-8097-2021
    DUSG is a useful diagnostic tool for the follow- up of renal transplant recipients. The measurement of intrarenal arterial RI by DUSG has been proven to predict short-term AF. The aim of the study was to evaluate the predictive value of DUSG performed during the early after RTx on long-term AF. Seventy patients were enrolled into study. DUSG was performed at third and seventh days after RTx. Patients were divided into two groups according to rate of recovery of graft function as patients with normal graft function and abnormal graft function. Although the RI values were correlated with the AF early after transplantation, they were not correlated with long-term AF. However, the rate of recovery of graft function at early period after RTx was correlated with creatinine level at first year and with glomerular filtration rate at first year and last visit. Although the RI has no predictive value for long-term AF, the rate of recovery of graft function at early post-transplantation period has predictive value for long-term AF; patients with higher RI values early after RTx should be followed carefully for the development of chronic allograft injury.
  • No Thumbnail Available
    Item
    Ultrasonography Findings of Urinary Tract Infection After Kidney Transplant: A Case Report
    (2018) Tezcan, Sehnaz; Soy, Ebru Ayvazoglu; Uslu, Nihal; Haberal, Mehmet; 0000-0001-7204-3008; 0000-0002-0993-9917; 0000-0002-6733-8669; 0000-0002-3462-7632; 29528007; AAC-5566-2019; ABC-5258-2020; AAJ-8097-2021
    Urinary tract infection is the most common complication after kidney transplant and often is associated with graft loss and mortality. Ultrasonography is the most widely applied imaging modality for diagnosis of complications after kidney transplant. Here, we report a case of a 52-year-old male patient who underwent renal transplant 1 month earlier and who presented with fever, leukocytosis, and leukocyturia. Klebsiella pneumoniae was found in the urine and blood cultures. Ultrasonography revealed multiple, ill-defined margined, hypoechoic areas and cysts within the cortex. Both clinical findings and ultrasonography findings were resolved after antimicrobial therapy. One month later, the patient presented again with fatigue, leukocytosis, and leukocyturia. Blood and urine culture results were consistent with Klebsiella pneumoniae. Ultrasonography revealed large hypoechoic mass, including multiple cysts in the upper pole of the transplanted kidney. Doppler ultrasonography showed increased vascularity within the hypoechoic mass and surrounding parenchyma. Renal parenchymal echogenicity was also increased in the upper pole. Ultrasonography-guided percutaneous drainage was performed. Clinical, laboratory, and ultrasonography findings were resolved after antimicrobial therapy. Ultrasonography plays an important role in the diagnosis and evaluation of the treatment response of urinary tract infections after kidney transplant.
  • No Thumbnail Available
    Item
    Preferred Music Lowers Anxiety Levels and Pain Perception While Promoting Patient Satisfaction in Women Undergoing Ultrasound-guided Breast Biopsy: Randomized Controlled Study
    (2023) Ozturk, Funda Ulu; Turnaoglu, Hale; Uslu, Nihal; 0000-0003-2782-2824; 35938620
    Background Image-guided breast biopsies are well accepted, yet stressful procedures for patients in radiology clinics. Purpose To investigate the effect of music on anxiety, pain, and patient satisfaction related to a breast biopsy session. Material and Methods After approval of institutional review board and giving informed consent, 93 women scheduled for ultrasound-guided breast biopsy or stereotactic wire localization were prospectively enrolled in this randomized controlled study. Patients were referred into two groups either listening to music of their own choice from three options of genre list during the procedure or not. Immediately before and after the biopsy session, participants were asked to complete questionnaires for measuring anxiety (State-Trait Anxiety Inventory, Beck Anxiety Inventory), pain, and patient satisfaction (visual analog scale). Sociodemographic data were described, and the duration was noted at the end. Statistical analysis was made using paired samples t-test, chi-square test, independent samples t-test, and Mann-Whitney U test. Results Except for the duration, demographic characteristics were statistically similar between the two groups. Trait and preprocedural state anxiety scores did not have significant difference between the groups. Both groups showed lowered state anxiety values after the biopsy (P < 0.05) and there was statistically significant reduction in state anxiety levels of music group (10.35 +/- 7.5 music vs. 7 +/- 7.98 control; P = 0.024). Pain perception was fewer (P < 0.05) and patient satisfaction was greater (P < 0.05) through the implementation of music. Conclusion Music intervention reduces anxiety and pain and thereby increases patient satisfaction during ultrasound-guided breast biopsies.
  • No Thumbnail Available
    Item
    Left Renal Vein Entrapment In Postural Proteinuria: The Diagnostic Utility Of The Aortomesenteric Angle
    (2022) Gulleroglu, Nadide Basak; Gulleroglu, Kaan; Uslu, Nihal; Baskin, Esra; https://orcid.org/0000-0002-8533-3781; https://orcid.org/0000-0003-1434-3824; 35789292; AAJ-8833-2021
    Nutcracker syndrome related to the left kidney vein compression is a cause of orthostatic proteinuria during childhood. Some studies have shown that the ratios between maximum velocities and anterior-posterior diameters of hilar and aortomesenteric segments of the left kidney vein between upright and supine positions must be more than 4 in order to make a Nutcracker syndrome diagnosis. Our aim was to investigate whether the use of a decrease in aortomesenteric angle between upright and supine positions in the presence of isolated orthostatic proteinuria can be a criterion for the diagnosis of Nutcracker syndrome. Relevant patient information, which included demographic data, clinical examination findings, laboratory data, urinary system ultrasound, and kidney color flow Doppler ultrasound results, were prospectively collected. Thirty-nine pediatric patients with orthostatic proteinuria were included in the study. Left kidney vein compression findings were demonstrated in 31 patients. The ratio of maximum velocities of hilar and aortomesenteric segments of the left kidney vein between upright and supine positions was above 4 in only 7 of our patients. Ratio of aortomesenteric angle between upright and supine positions was significantly decreased for patients with left kidney vein compression findings. Conclusion: The use of a decrease in the ratio of aortomesenteric angle between upright and supine positions in the presence of orthostatic proteinuria, instead of the ratios for maximum velocities and anterior-posterior diameters of hilar and aortomesenteric segments, can be more helpful for the diagnosis of Nutcracker syndrome in the differential diagnosis of orthostatic proteinuria.