Person: ERGELEN, RABİA
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ERGELEN
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RABİA
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Publication Open Access Is renal abscess still a problem?(MARMARA UNIV, FAC MEDICINE, 2021-01-26) ALPAY, HARİKA; Sak, Mehtap; Gokce, Ibrahim; Cicek, Neslihan; Guven, Sercin; Ergelen, Rabia; Yildiz, Nurdan; Alpay, HarikaRenal abscess, the accumulation of infected fluid in the kidney, is a rare condition seen in children as well as adults. It leads to long term hospital admission and antibiotic use. Early diagnosis is an important factor in the outcome of renal abscess because the management may differ. Urinalysis test results and radiologic imaging findings of the patients who are admitted to hospital with complaints of fever, vomiting, abdominal pain or flank pain are important for the early diagnosis. Undertreated cases have high risk for renal scar formation. In this paper, we aim to present three pediatric patients, who showed the complication of renal abscess and were treated with long term antibiotic use without a need for surgical drainage.Publication Metadata only A comparison of FibroMeter (TM) NAFLD Score, NAFLD fibrosis score, and transient elastography as noninvasive diagnostic tools for hepatic fibrosis in patients with biopsy-proven non-alcoholic fatty liver disease(INFORMA HEALTHCARE, 2014) ÇELİKEL, ÇİĞDEM; Aykut, Umut Emre; Akyuz, Umit; Yesil, Atakan; Eren, Fatih; Gerin, Fatma; Ergelen, Rabia; Celikel, Cigdem Ataizi; Yilmaz, YusufBackground: Noninvasive markers that purport to distinguish patients with non-alcoholic fatty liver disease (NAFLD) with fibrosis from those without must be evaluated rigorously for their classification accuracy. Herein, we seek to compare the diagnostic performances of three different noninvasive methods (FibroMeter (TM) NAFLD score, NAFLD Fibrosis score (NFSA), and Transient Elastrography [TE]) for the detection of liver fibrosis in NAFLD patients. Methods: A total of 88 patients with biopsy-proven NAFLD were included. The Kleiner system was used for grading fibrosis in liver biopsies. The FibroMeter (TM) NAFLD score was determined using a proprietary algorithm (regression score). The NFSA score was calculated based on age, hyperglycemia, body mass index, platelets, albumin and serum aminotransferase levels. TE was performed using the Fibroscan apparatus. Results: The sensitivities/specificities for the FibroMeter (TM) NAFLD score, NFSA, and TE for the diagnosis of significant fibrosis (F2 + F3 + F4 fibrosis) were 38.6%/86.4%, 52.3%/88.6%, and 75.0%/93.2%, respectively. The areas under the receiver operating characteristic curves of TE were significantly higher than those of both the FibroMeter (TM) NAFLD score and NFSA. No significant differences were found between the FibroMeter (TM) NAFLD score and NFSA for the detection of significant and severe fibrosis, although the diagnostic performance of the FibroMeter (TM) NAFLD score was higher than that of the NFSA score for cirrhosis. Conclusions: In summary, TE showed the best diagnostic performance for the noninvasive assessment of liver fibrosis in NAFLD patients. The diagnostic performances of the FibroMeter (TM) NAFLD score and NFSA did not differ significantly for the detection of both significant and severe fibrosis.Publication Metadata only Nonalcoholic Steatohepatitis Score is an Independent Predictor of Right Ventricular Dysfunction in Patients with Nonalcoholic Fatty Liver Disease(WILEY-HINDAWI, 2015) SÜNBÜL, MURAT; Sunbul, Murat; Kivrak, Tarik; Durmus, Erdal; Akin, Hakan; Aydin, Yucel; Ergelen, Rabia; Yilmaz, Yusuf; Agirbasli, MehmetObjectiveNonalcoholic fatty liver disease (NAFLD) is associated with increased risk of cardiovascular disease and impaired left ventricular (LV) function, yet the impact of NAFLD on right ventricular (RV) function remains unclear. We investigate the RV functional properties in patients with NAFLD. MethodsNinety consecutive patients with the diagnosis of biopsy-proven NAFLD and 45 age- and sex-matched controls were included. All patients underwent an echocardiographic examination. RV function was evaluated by two-dimensional (2D) speckle-tracking echocardiography (STE). ResultsMean fibrosis stage and nonalcoholic steatohepatitis (NASH) scores were 1.31.1 and 5.2 +/- 1.6, respectively. NAFLD patients displayed decreased RV function compared to controls. NAFLD patients with liver fibrosis (67 patients) had significantly lower RV function assessed by GLS (global longitudinal strain) compared to patients without liver fibrosis (18.9 +/- 3.4% vs. 21.6 +/- 2.3%, P<0.001). NASH score 5 was associated with lower RV-GLS (18.9 +/- 3.1% vs. 21.0 +/- 3.4%, P=0.006). NASH score inversely correlated with RV-GLS (r=-0.370, P<0.001) such as patients with impaired RV-GLS (<19%) showed significantly higher NASH score compared to normal RV-GLS group (5.8 +/- 1.4 vs. 4.8 +/- 1.7, P=0.009). Logistic regression analysis revealed that NASH score was an independent predictor of impaired RV function in patients with NAFLD. ConclusionsPatients with NAFLD have impaired RV function. NASH score inversely correlates with RV-GLS and independently predicts impaired RV function in patients with NAFLD.Publication Open Access Common femoral vein thickness measurement as a diagnostic test in incomplete behcet's disease(2022-06-01) ALİBAZ ÖNER, FATMA; ERGELEN, RABİA; ERGUN, SAFİYE ATLAS TÜLİN; DİRESKENELİ, RAFİ HANER; Alibaz-Oner F., Ergelen R., Temiz F., Agackiran S. K. , Soydemir E., Ergun T., DİRESKENELİ R. H.Publication Metadata only Comparison of Doppler ultrasound and transient elastography in the diagnosis of significant fibrosis in patients with nonalcoholic steatohepatitis(SPRINGER, 2016) ÇELİKEL, ÇİĞDEM; Ergelen, Rabia; Yilmaz, Yusuf; Asedov, Ruslan; Celikel, Cigdem; Akin, Hakan; Bugdayci, Onur; Altun, Ersan; Tuney, DavutBackground: Liver fibrosis is an important prognostic determinant in patients with nonalcoholic steatohepatitis (NASH). Hepatic artery resistivity index (HARI) is a doppler ultrasonography (US) parameter that is used to follow up microcirculatory resistance in fatty liver. We aimed to asses whether it is possible to demonstrate significant fibrosis by means of doppler US in comparison with transient elastography (TE) and liver biopsy in NASH patients. Patients and methods: A total of 63 (mean age 47.1 +/- 8.4 years, 39 male, 24 female) biopsy-proven NASH patients were enrolled in this prospective study. The study population was classified into two groups: significant and no-significant fibrosis patients. Doppler US and TE were performed in two groups. Results: HARI and TE values were significantly higher in significant fibrosis group (0.81 +/- 0.05 vs. 0.63 +/- 0.14, p < 0.0005; 15.9 +/- 4.8 vs. 6.2 +/- 2.6 kilopascals, p < 0.0005; respectively). Based on the ROC curve, the optimal cut-off value of HARI for a significant fibrosis was >0.75, which yielded a sensitivity of 78% and a specificity of 75%, with the area under the curve at 0.90. The optimal cut-off value of TE for a significant fibrosis was >9.8 kilopascals, which yielded a sensitivity of 90% and a specificity of 91%, with the area under the curve at 0.95. HARI values were moderately correlated with TE values (r = 0.53, p < 0.001). Conclusion: Doppler US has moderate % sensitivity and % specificity, which is lower compared with TE for the diagnosis significant fibrosis. However, it may be used as an alternative method for the assessment of fibrosis in patients with NASH who are not good candidates for TE evaluation.Publication Open Access Open safety pin ingestion: A pediatric case: Can it be spontaneously eliminated or not?(MARMARA UNIV, FAC MEDICINE, 2017-05-14) ERGELEN, RABİA; Yasoz, Guniz; Bicer, Suat; Ulku Ozer, Safiye; Sogutlu, Yakup; Ergelen, Rabia; Col, DefneForeign body ingestion is a common problem in childhood. Sharp objects such as needles, toothpicks or open safety pins can also be ingested. A 13-month-old-boy was admitted to our pediatric emergency department with the suspicion of safety pin ingestion. The boy was taken to a private hospital and an abdominal X-ray was obtained. The open safety pin was seen in the pylorus and he was referred to a university hospital. When he arrived to our pediatric emergency department, an abdominal X-ray was retaken, and an open safety pin was seen in the first part of the duodenum. The patient was hospitalized for observation. After twenty hours, a control X-ray was taken; the open safety pin was seen in the ascending colon. The child was discharged from hospital, and instructions were given to the family for watching his stool closely. The day after, we called the family and learned that the open safety pin was eliminated spontaneously from stool. Infants and children with safety pin ingestion can be closely followed clinically without complication and there will be no need for an endoscopy and/or surgery. An open safety pin ingested small child was reported with the aim to draw attention to safety pin ingestion.Publication Open Access Broadly effective metabolic and immune recovery with C5 inhibition in CHAPLE disease(NATURE RESEARCH, 2021-02) ÖZEN, AHMET OĞUZHAN; Ozen, Ahmet; Kasap, Nurhan; Vujkovic-Cvijin, Ivan; Apps, Richard; Cheung, Foo; Karakoc-Aydiner, Elif; Akkelle, Bilge; Sari, Sinan; Tutar, Engin; Ozcay, Figen; Uygun, Dilara Kocacik; Islek, Ali; Akgun, Gamze; Selcuk, Merve; Sezer, Oya Balci; Zhang, Yu; Kutluk, Gunsel; Topal, Erdem; Sayar, Ersin; Celikel, Cigdem; Houwen, Roderick H. J.; Bingol, Aysen; Ogulur, Ismail; Eltan, Sevgi Bilgic; Snow, Andrew L.; Lake, Camille; Fantoni, Giovanna; Alba, Camille; Sellers, Brian; Chauvin, Samuel D.; Dalgard, Clifton L.; Harari, Olivier; Ni, Yan G.; Wang, Ming-Dauh; Devalaraja-Narashimha, Kishor; Subramanian, Poorani; Ergelen, Rabia; Artan, Reha; Guner, Sukru Nail; Dalgic, Buket; Tsang, John; Belkaid, Yasmine; Ertem, Deniz; Baris, Safa; Lenardo, Michael J.CHAPLE disease is a lethal syndrome caused by genetic loss of the complement regulatory protein CD55. Lenardo, Ozen and their colleagues report that blockade of C5 complement activation in a small cohort of pediatric patients with CHAPLE disease reduced gastrointestinal pathology and restored their immunity and growth. Complement hyperactivation, angiopathic thrombosis and protein-losing enteropathy (CHAPLE disease) is a lethal disease caused by genetic loss of the complement regulatory protein CD55, leading to overactivation of complement and innate immunity together with immunodeficiency due to immunoglobulin wasting in the intestine. We report in vivo human data accumulated using the complement C5 inhibitor eculizumab for the medical treatment of patients with CHAPLE disease. We observed cessation of gastrointestinal pathology together with restoration of normal immunity and metabolism. We found that patients rapidly renormalized immunoglobulin concentrations and other serum proteins as revealed by aptamer profiling, re-established a healthy gut microbiome, discontinued immunoglobulin replacement and other treatments and exhibited catch-up growth. Thus, we show that blockade of C5 by eculizumab effectively re-establishes regulation of the innate immune complement system to substantially reduce the pathophysiological manifestations of CD55 deficiency in humans.Publication Open Access VENOUS VESSEL WALL THICKNESS IN LOWER EXTREMITY IS INCREASED IN MALE BEHCET'S DISEASE PATIENTS WITHOUT VASCULAR INVOLVEMENT(BMJ PUBLISHING GROUP, 2017-06) ALİBAZ ÖNER, FATMA; Alibaz-Oner, F.; Mutis, A.; Ergelen, R.; Erturk, Z.; Ergun, T.; Direskeneli, H.Publication Open Access ASSESSMENT OF FEMORAL VEIN WALL THICKNESS WITH DOPPLER US AS A DIAGNOSTIC TOOL FOR BEHCET'S DISEASE(BMJ PUBLISHING GROUP, 2020-06) ALİBAZ ÖNER, FATMA; Alibaz-Oner, F.; Ergelen, R.; Yildiz, Y.; Yazici, A.; Aldag, M.; Cefle, A.; Artim-Esen, B.; Mumcu, G.; Ergun, T.; Direskeneli, H.Publication Open Access Duration of ciprofloxacin use is important in the development of abdominal aortic aneurysm in a rat model(2022-11-01) ÖZYILMAZ YAY, NAGEHAN; ERGELEN, RABİA; AKAKIN, DİLEK; GÜLHAN, REZZAN; Çulpan Y., Keçeci İ., Sandıkçı İ., Gökçe Ş., Göker H., ÖZYILMAZ YAY N., ERGELEN R., AKAKIN D., GÜLHAN R.BACKGROUND: Recent findings suggest that fluoroquinolones, most prescribed antibiotic to treat various infections, have increased abdominal aortic aneurysm formation. We aimed to investigate the relation of the development of abdominal aortic aneurysm and the duration of ciprofloxacin use. METHODS: Male Sprague-Dawley rats were divided into 2 groups to administer saline to the control groups and CaCl2 to the aneurysm groups. These groups were then divided into 3 subgroups: intraperitoneal saline, ciprofloxacin for 2 weeks, and ciprofloxacin for 4 weeks. At the end of 4 weeks, the diameter of abdominal aorta was determined by ultrasonography and animals were sacrificed to obtain abdominal aorta specimens. Elastic fiber fracture, tunica media layer thickness, and aortic tissue damage were evaluated histologically. RESULTS: Aortic diameter of control-saline (2.15 mm ± 0.06), control-2 weeks (2.25 mm ± 0.06), and control-4 weeks (3.31 mm ± 0.09) ciprofloxacin groups was significantly different (P .05). CONCLUSION: The study showed that ciprofloxacin caused injury in the aortic wall but not a significant change in the thickness of the aortic tunica media layer. The duration of ciprofloxacin use was important in the development of aneurysm and aneurysm severity.