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ERGELEN, RABİA

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ERGELEN

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RABİA

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2014 - 201924
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End date: 2019 × Start date: 2010 ×

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    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, Yusuf
    Background: 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.
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    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, Mehmet
    ObjectiveNonalcoholic 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.
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    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, Davut
    Background: 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.
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    PublicationOpen 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, Defne
    Foreign 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.
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    PublicationOpen 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.
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    PublicationOpen Access
    Making decisions for surgical intervention in neonates with necrotizing enterocolitis and the selection of appropriate surgical intervention
    (MARMARA UNIV, FAC MEDICINE, 2017-01-15) MEMİŞOĞLU, ASLI; Karadeniz Cerit, Kivilcim; Ergelen, Rabia; Abdullayev, Tural; Unkar, Zeynep Alp; Memisoglu, Asli; Kiyan, Gursu; Dagli, E. Tolga
    Objective: Necrotizing enterocolitis (NEC) is one of the most common conditions requiring surgical intervention in the neonatal period. The decision for surgical intervention in NEC is difficult and the surgical procedures differ according to the condition of the patient. This study assesses the decision for surgical intervention in patients being followed with a preliminary diagnosis of NEC and the appropriate surgical procedure. Material and Method: The files of patients undergoing surgery with a diagnosis of NEC at the Marmara University Hospital Neonatal Intensive Care Unit between 15.07.2013-15.07.2015 were studied retrospectively. Patients were evaluated for the following: gestational age, birth weight, gender, time of onset of symptoms, abdominal distention, tenderness, presence of abdominal erythema, hypotension, acidosis, thrombocytopenia, radiological findings, surgical timing and post-operative follow up. Results: A total of 10 neonates (7 boys, 3 girls) were treated surgically with an NEC diagnosis. The average gestational age of the patients was 27.6 weeks (22-37 weeks), and the median birth weight was 710 grams (400-3750). Average onset of symptoms was found to be 8.1 days (2-30) postnatally. Abdominal distention and tenderness (10), hypotension (4), and abdominal erythema (3) were observed in patients upon physical examination. Acidosis (7) and thrombocytopenia (6) were observed in patients in laboratory findings. Free fluid (4), thickening of the intestinal wall ans (3), pneumatosis intestinalis (1), portal venous gas (1) were observed in patients during the assessment of the abdominal ultrasonography (US). Three patients whose direct x-ray evaluations were grade III underwent peritoneal drainage. The drain site of one of these patients closed by itself, and there was no need for further surgery for the patient. Laparotomy was carried out a day after clinical stabilization was achieved. Our third patient, the lowest birth weight in our series, was lost immediately following the peritoneal drainage process. Peritoneal drainage was planned in two other grade III patients based on the radiological findings. However, due to the appearance of necrotic bowel segments from the incision site, they underwent bowel resection and ileostomy during a bedside laparotomy. One of these patients improved clinically, but the other patient was lost in the early stages. Due to the deterioration seen in the clinical findings of 5 patients who were radiologically grade II, the decision for laparotomy was made initially. All of these 5 patients were discharged after an uneventful postoperative period. Conclusion: In patients who are grade II radiologically, the decision for surgical intervention in an operating room can be made according to clinical deterioration. In infants who are grade III, and whose clinical condition is poor, bedside surgical intervention in the neonatal intensive care unit is preferable..
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    Prostat kanseri̇ radyoterapi̇si̇nde transperneal hi̇drojel uygulaması tekni̇k ve tolerabi̇li̇te çok merkezli̇ çalışma sonuçları
    (2014-04-23) ATASOY, BESTE MELEK; ERGELEN, RABİA; İĞDEM Ş., BARLAN M., ALÇO G., ÖZGEN Z., ATASOY B. M., ERGELEN R., İRİBAŞ A., AĞAOĞLU F., TENEKECİ N.
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    Us guided percutaneous renal biopsies in children and adolescents: single center experience and assesment of risk factors associated with complications
    (2018-02-28) GÖKCE, İBRAHİM; BUĞDAYCI, ONUR; ERGELEN, RABİA; ASADOV R., GÜNDOĞMUŞ C. A., GÖKCE İ., SAK M., BUĞDAYCI O., ERGELEN R., EKİNCİ G., BALTACIOĞLU F.
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    PublicationOpen Access
    Computed tomography findings of primary epiploic appendagitis as an easily misdiagnosed entity: Case series and review of literature
    (TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2017) DEMİRBAŞ, BAHA TOLGA; Ergelen, Rabia; Asadov, Ruslan; Ozdemir, Burcu; Tureli, Derya; Demirbas, Baha Tolga; Tuney, Davut
    BACKGROUND: Primer epiploic appendagitis (PEA) is an uncommon condition. METHODS: We retrospectively reviewed the clinical records and computed tomography (CT) findings of 45 patients with PEA. RESULTS: On the basis of physical examination and pain localization, presumptive clinical diagnosis was acute appendicitis (n=13), acute cholecystitis (n=2), acute diverticulitis (n=19), renal colic (n=7) and ovarian pathology (n=4). CONCLUSION: Although it has no characteristic clinical and laboratory features, CT is the best modality for accurate diagnosis of PEA.
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    Venous vessel wall thickness in lower extremity is increased in male patients with Behcet's disease
    (SPRINGER LONDON LTD, 2019) ALİBAZ ÖNER, FATMA; Alibaz-Oner, Fatma; Ergelen, Rabia; Mutis, Aydan; Erturk, Zeynep; Asadov, Ruslan; Mumcu, Gonca; Ergun, Tulin; Direskeneli, Haner
    Vascular involvement, especially in young males, is seen in up to 40% of the patients with Behcet's disease (BD) and is a major cause of mortality and morbidity. In this study, we investigated vessel wall thickness (VWT) and dilatation in lower extremity veins with Doppler ultrasound (US) in male BD patients. Sixty-one male patients with BD, 37 healthy male controls (HC) and 27 male patients, with ankylosing spondylitis (AS), were included in the study. Venous Doppler US was performed by an experienced radiologist blinded to cases. Bilateral common femoral vein (CFV) wall thickness and great/small saphenous vein (SV) dilatations were assessed. All venous measurements were significantly higher in BD compared to AS and HC (p<0.001 for all). Both right and left extremity CFV thicknesses had a high area under the ROC curve (>0.8). Cut-off values for right and left CFV thicknesses for BD was 0.49 and 0.48mm, respectively. High sensitivity and specificities are observed for both measurements (right CFV: sensitivity 81%, specificity 78.4%; left CFV: sensitivity 82.8%, specificity 81.1%). We found increased CFV thickness in BD patients independent of vascular involvement. As a similar change was not observed in controls, increased CFV thickness may be a specific sign of venous inflammation in BD. Our acceptable sensitivity and specificity values of CFV measurements suggest that assessment of femoral vein thickness with US may be a candidate diagnostic tool, especially in young males suspected of BD.