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Öğe Association of Urinary Tract Infection and Ultrasonographic Finding of Bladder Debris in Pediatric Patient(Aves Yayincilik, Ibrahim Kara, 2019) Ulubaba, Hilal Er; Dogan, Gulec Mert; Saglik, SemihObjective: Early diagnosis and treatment of urinary tract infections (UTI) in children has clinical importance since the signs and symptoms can be nonspecific. The aim of this study was to investigate the association between bladder debris which is commonly seen at the process of ultrasonography (USG) and positive urine culture in pediatric patients that will alert the clinicians in the diagnosis of UTI when the signs and symptoms are nonspecific. Material and Methods: A retrospective analysis of pediatric patients who underwent USG examination between February 2017 and February 2018 was conducted. USG reports were analyzed from the aspects of layering and floating debris. Patients who were formerly diagnosed and treated for urinary tract infection (UTI) and patients who had genitourinary system abnormalities (Hydronephrosis, Vesicoureteral Reflux, neurogenic bladder etc.) was excluded from the study. In the 0-11 age group, we detected 93 patients suffering from debris, who also had urine culture. These patients were compared with 50 patients in the control group in the same age group, who had normal USG and urine culture. Results: Ninety-three patients with bladder debris were classified under two groups as layering and floating debris. In Group 1, there were 21 patients with layering debris and there were 72 patients with floating debris in Group 2. Control patients group consisting of 50 patients was referred to as Group 3. According to multiple logistic regression analysis, a statistically significant increase was detected at the rate of positive urine culture in patients with layering debris (Group 1) and patients with floating debris (Group 2) compared to control patients (Group 3). However, increase at the rate of positive urine culture (UC) was higher in patients with layering debris. Conclusion: Statistically significant increase at the rate of positive urine culture (UC) was seen in the pediatric patients who had bladder debris at ultrasonography. The increase in patients with layering debris is higher. In the pediatric patients group, bladder debris should be an alerting finding for the diagnosis of urinary tract infection (UTI).Öğe Canavan disease: a rare form of leukodystrophy(2017) Dogan, Gulec Mert; Sığırcı, AhmetCanavan disease (CD) is a rare autosomal recessive leukodystrophy characterized by spongy degeneration of the white matter of brain. It is characterized by accumulation of N-acetyl aspartic (NAA) acid in mitochondria which inhibits myelin synthesis. Axial hypotonia, ataxia, defects in cognitive functions, defective visual follow and sucking, irritability and macrocephaly are seen in thepatients. Increased high NAA peaks are seen magnetic resonance spectroscopy (MRS). Here we report a case with defective head control and could not sit without support who had no other symptoms before. She had axial hypotonia and bilateral nystagmus on neurological examination. The diagnosis of CD is based on these clinical findings and radiologic evaluations.Öğe Canavan Disease: A Rare Form Of Leukodystrophy(2017) Dogan, Gulec Mert; Sigirci, AhmetCanavan disease (CD) is a rare autosomal recessive leukodystrophy characterized by spongy degeneration of the white matter of brain. It is characterized by accumulation of N-acetyl aspartic (NAA) acid in mitochondria which inhibits myelin synthesis. Axial hypotonia, ataxia, defects in cognitive functions, defective visual follow and sucking, irritability and macrocephaly are seen in the patients. Increased high NAA peaks are seen magnetic resonance spectroscopy (MRS). Here we report a case with defective head control and could not sit without support who had no other symptoms before. She had axial hypotonia and bilateral nystagmus on neurological examination. The diagnosis of CD is based on these clinical findings and radiologic evaluations.Öğe A case of cardiac cyst hydatid with multiple system involvement(2021) Dogan, Gulec Mert; Dogan, Sait Murat; Tasolar, Sevgi; Okut, Gokalp; Sigirci, Ahmet; Elkiran, Ozlem; Karakurt, CemsitThe larval form of the Echinococcus granulosus causes cystic echinococcosis. The liver and the lungs are the most commonly affected organs. Echinococcosis can also be present in other organs although it is rare. We reported a case with sacral bone, cardiac, lung and liver involvement. Clinical and radiological findings of this unique case were discussed. At the Thoracic Computed On the thoracic computed tomography (CT) scan of a 16-year-old female patient was seen multiple parenchymal and subpleural nodular lesions and a cystic mass in the right ventricular cavity. Echocardiographic examination of the patient also observed on CT. Most cases of cardiac cystic echinococcosis were occurred on adult patients, while only 20 cases were in children. For the 20 reported cases in children, there were 9 cases of cardiac echinococcosis involving left ventricle. Because of the possible complications in the presence of cardiac hydatid cyst, treatment should be surgery.Öğe A case of cardiac cyst hydatid with multiple system involvement(2021) Dogan, Gulec Mert; Dogan, Sait Murat; Tasolar, Sevgi; Okut, Gokalp; Sığırcı, Ahmet; Elkıran, Özlem; Karakurt, CemşitAbstract: The larval form of the Echinococcus granulosus causes cystic echinococcosis. The liver and the lungs are the most commonly affected organs. Echinococcosis can also be present in other organs although it is rare. We reported a case with sacral bone, cardiac, lung and liver involvement. Clinical and radiological findings of this unique case were discussed. At the Thoracic Computed On the thoracic computed tomography (CT) scan of a 16-year-old female patient was seen multiple parenchymal and subpleural nodular lesions and a cystic mass in the right ventricular cavity. Echocardiographic examination of the patient also observed on CT. Most cases of cardiac cystic echinococcosis were occurred on adult patients, while only 20 cases were in children. For the 20 reported cases in children, there were 9 cases of cardiac echinococcosis involving left ventricle. Because of the possible complications in the presence of cardiac hydatid cyst, treatment should be surgery.Öğe A case of cardiac cyst hydatid with multiple systeminvolvement(2021) Dogan, Gulec Mert; Dogan, Sait Murat; Taşolar, Sevgi; Okut, Gokalp; Sığırcı, Ahmet; Elkiran, Ozlem; Karakurt, CemsitThe larval form of the Echinococcus granulosus causes cystic echinococcosis. The liver and the lungs are the most commonlyaffected organs. Echinococcosis can also be present in other organs although it is rare. We reported a case with sacral bone, cardiac,lung and liver involvement. Clinical and radiological findings of this unique case were discussed. At the Thoracic Computed On thethoracic computed tomography (CT) scan of a 16-year-old female patient was seen multiple parenchymal and subpleural nodularlesions and a cystic mass in the right ventricular cavity. Echocardiographic examination of the patient also observed on CT. Mostcases of cardiac cystic echinococcosis were occurred on adult patients, while only 20 cases were in children. For the 20 reportedcases in children, there were 9 cases of cardiac echinococcosis involving left ventricle. Because of the possible complications in thepresence of cardiac hydatid cyst, treatment should be surgery.Öğe A case of gliosarcoma in a child with neurofibromatosis type 1(2020) Dogan, Gulec Mert; Sigirci, Ahmet; Cengiz, Aslinur; Erbay, Mehmet Fatih; Gokce, HasanGliosarcoma (GS) is a rarely seen form of glioblastoma. These tumors are mostly seen in males older than 60 years of age. It is extremely rare in pediatric central nervous system (CNS) tumors. In this case report, we present a 3-year-old boy with a giant gliosarcoma. Magnetic resonance (MR) imaging and histopathologic findings are discussed. A 3 year-old boy with a clinically diagnosed NF-1 was admitted to the emergency department with a complaint of intractable vomiting. Magnetic resonance imaging (MRI) of the brain was suggestive of a large lobulated mass lesion in the left parietal lobe extending to the vertex and slightly compressing the left lateral ventricle. The final histopathologic diagnosis of the tumor was considered as gliosarcoma. To our knowledge, this case constitutes the first youngest case with neurofibromatosis type 1 reported in the literature in all pediatric cases of GS.Öğe A case of pediatric infratentorial oligodendroglioma(2019) Dogan, Gulec Mert; Sigirci, Ahmet; Samdanci, EminePediatric posterior fossa tumors most commonly are pilocytic astrocytomas (PA), ependymomas, medulloblastomas, and atypical teratoid rhabdoid tumor (ATRT). MRI has some special radiological findings which can be used in the differential diagnosis. We report on the radiologic images and the clinical course of a 3 year-old-girl with oligodendroglial tumor arising from the cerebellum. There were no focal deficits in the neurological examination. MRI revealed a left cerebellar lesion extending into the left cerebellopontine region causing a pressure and shift in the fourth ventricle, pons and mesencephalon. She underwent a left occipital craniectomy and total tumor decompression. In the pathological examination, mainly oligodendroglial cells were seen in the tumor and they had round nucleus and perinuclear halos. No recurrence was detected at MRI and CT at 6 months postoperatively. Except for the following most common tumors as PA, ependymoma, medulloblastoma and AT/RT in the posterior fossa, the oligodendroglioma must be considered in the differential diagnosis.Öğe Classical Maple Syrup Urine Disease successfully treated with living donor liver transplantation(2021) Dogan, Gulec Mert; Dogan, Sait Murat; Okut, Gokalp; Sigirci, Ahmet; Yilmaz, SezaiMaple syrup urine disease (MSUD) is a disease that causes ketoacid accumulation in body. Diffusion-weighted imaging (DWI) is an important imaging modality for the diagnosis. Two children were diagnosed with MSUD at the neonatal period. They had uncontrolled ketosis and epileptic seizures although they were in compliance with their medical nutrition. Their DWIs were similar and showed high signal intensity localized within the myelinated white matter areas. Both of the patients were treated with living donor liver transplantation. The patients with classic form of MSUD are normal at birth. If the disease is not diagnosed and treated early, it can lead to serious neurological complications. Most researchers conclude that, the best choice for detecting MSUD encephalopathy in newborns is DWI. The traditional treatment of MSUD had been a protein-restricted diet until the liver transplantation became an alternative and better option for the cure of the patients..Öğe Comparison of posterior cranial fossa morphometric measurements in Chiari type I patients with and without syrinx cavity on magnetic resonance imaging(Int Scientific Information Inc, 2022) Dogan, Gulec Mert; Sigirci, Ahmet; Tetik, Bora; Pasahan, Ramazan; Onal, Cagatay; Arslan, Ahmet K.Purpose: To compare the posterior fossa measurements of Chiari type I malformation (CHM1) patients with and without syrinx and with a control group. Material and methods: The patients with syrinx were divided into 2 groupd according to syrinx width/cord width (S/C) ratios: group 1 - S/C ratio < 50%; group 2 - S/C ratio > 50%. The length of the clivus, the AP length of the foramen magnum, the AP length of the posterior fossa, the perpendicular distance between the McRae line and (a) the splenium of corpus callosum, (b) the pons, and (c) the fastigium of the 160 patients and of the 160 control patients were statistically compared. In addition, the measurements of the patients with and without syrinx, according to the S/C ratio, were statistically compared. Results: Syrinx was present in 59 (36.8 %) of the 160 patients. The S/ C ratio was < 50% in 30 (50.9 %) of them, and S/C ratio > 50% in 29 (49.1%) of them. All the measurements in the patient group, except of the AP length of the foramen magnum, were statistically significantly lower than in the control group (p = 0.001). There was no significant difference in the measurements of the patients with syrinx group 1 and the patients without syrinx, but the AP length of posterior fossa was statistically significantly lower in the patients with syrinx group 2 than the patients without syrinx (p = 0.03). Conclusion: The S/C ratio can be a guide to the underlying aetiology.Öğe Comparison of Urinary Tract Dilatation and Society of Fetal Urology systems in the detection of vesicourethral reflux and renal scar(Int Scientific Information Inc, 2021) Dogan, Gulec Mert; Sigirci, Ahmet; Cengiz, Aslinur; Tasolar, Sevgi Demiroz; Yildiz, Turan; Tabel, Yilmaz; Elmas, Ahmet TanerPurpose: The presence and degree of hydronephrosis is very important in the management of many diseases of the urinary tract. In this study, we aim to compare the sensitivity and specificity of 2 classification systems that are used for hydronephrosis grading in ultrasound, for reflux and scar detection. The classification systems were the Society of Fetal Urology (SFU) and Urinary Tract Dilatation (UTD). Material and methods: Ultrasounds and dimercaptosuccinic acid scintigraphies (DMSA) of all patients who underwent voiding cystourethrogram (VCUG) due to urinary tract infection were examined retrospectively. DMSA was accepted for scar detection and VCUG for reflux detection as reference methods. SFU classification was used for hydronephrosis in ultrasound reports, and UTD classification was made over the reports. Sensitivity, specificity, and positive and negative predictive values of UTD and SFU classification systems for reflux and scar detection were calculated, and these 2 systems were compared. Results: 103 (39%) of the patients were male and 162 (61%) were female. Pathologies were detected in 192 (35%) of 530 kidneys in ultrasound. In 110 (42%) of the children, reflux was detected in VCUG. Scars in DMSA were detected in only 16% (44) of 266 kidneys. Sensitivity, positive and negative predictive values of the UTD classification system were statistically significantly higher than the SFU system for scar and reflux detection (p < 0.01). Conclusions: If we use the UTD system in ultrasounds of patients with urinary tract infections, children reported as UTD 0 may not need VCUG, which reduces radiation exposure to children and the cost of the diagnostic interventions.Öğe Comprehensive Analysis of Long-term Splenic Volume Changes in Pediatric Liver Transplant Patients: Does It Correlate With Adverse Graft Outcomes?(Elsevier Science Inc, 2021) Dogan, Gulec Mert; Dogan, Sait Murat; Okut, Gokalp; Karakas, Serdar; Kutluturk, Koray; Ulubaba, Hilal Er; Sahin, Tevfik TolgaObjectives. Splenomegaly and hypersplenism caused by liver failure increase the mortality and morbidity of patients even after liver transplantation if they do not regress. We evaluated the relation of splenic volume change and transplanted liver function. Material and Methods. A total of 59 of 207 pediatric patients who had liver transplantation between 2013 and 2018 in our institute were evaluated. The relation of spleen volume changes (splenic volume to standard splenic volume ratio [SV/SSV]) were measured at 0, 1, 6, 12, 24, and 36 months of follow-up by constructing electronic three-dimensional structure of the spleen at dynamic computed tomography (CT), and the course of liver functions were evaluated. Results. The SV/SSV ratio decreases in the first postoperative 6 months. After 6 months, SV increases and SV/SSV increases gradually. In a normal functioning graft, SV/SSV significantly decreased in all time points (P < .001). In patients with adverse events, SV/SSV started to increase after 6 months. In patients with fulminant hepatic failure, SV/SSV started to increase after postoperative 6 months. Adverse events in patients with fulminant hepatic failure were more than the patients with chronic liver disease (58% vs 28%). There was an inverse correlation between SV/SSV and thrombocyte levels (P < .001). Conclusions. SV/SSV seems to be correlated to the adverse events (ie, rejection). Together with thrombocyte levels, it can be used as a noninvasive test for follow-up of transplant patients in terms of adverse events in graft function.Öğe Do antiepileptic drugs cause premature atherosclerosis by disturbing lipid metabolism?(Bayrakol Medical Publisher, 2022) Eskut, Neslihan; Soysuren, Cagla; Dogan, Gulec Mert; Tuna, Gamze; Toksoz, Feriha; Calis, Nazif; Cetiner, MustafaAim: The aim of this study was to evaluate susceptibility to atherosclerosis in epileptic patients on carbamazepine and valproic acid monotherapy with lipid profile, lipoprotein (a) (lp(a)), oxidized low-density lipoprotein (LDL), adiponectin, and carotid artery intima-media thickness measurements. Material and Methods: Of the 108 patients with epilepsy included in the study, 64 (36 female, 28 male) were receiving valproic acid monotherapy and 44 (25 female, 19 male) were receiving carbamazepine monotherapy. The control group comprised 48 (30 female, 18 male) healthy participants. Liver and kidney function tests, cholesterol, triglycerides, LDL, high-density lipoprotein (HDL), lp(a), oxidized LDL, adiponectin, and common carotid (CCA) and internal carotid artery (ICA) intima-media thickness (IMT) were investigated in both the patient and control groups. Results: Mean age was 32.34 +/- 12.41 years in the valproic acid group, 32.70 +/- 11.64 years in the carbamazepine group, and 35.81 +/- 11.76 years in the control group. Liver and kidney function test results were normal in all groups. Cholesterol levels were lower in the valproic acid group than the other groups. HDL levels were higher in the carbamazepine group than other groups. Adiponectin levels were lower in the valproic acid group. In all groups, cholesterol and LDL levels were higher in individuals older than 50 years old. When the patients were evaluated according to the duration of drug use, cholesterol and LDL levels were higher in patients who had used drugs for more than 5 years in the valproic acid group. There were no differences between the groups for triglyceride, oxidized LDL, or lp(a) levels or CCA and ICA IMT. Discussion: There are conflicting results in the literature regarding epilepsy and atherosclerosis associated with antiepileptic drug usage. In this study, no evidence was found of an increasing risk of arteriosclerosis associated with antiepileptic drugs by measuring lipids, lipoprotein, oxidized LDL, adiponectin levels, and CCA and ICA IMT. However, it is important to monitor lipid levels in the follow-up of patients with epilepsy, especially for patients requiring longterm antiepileptic therapy and also older patients.Öğe Evaluation of Salivary Glands by Ultrasonography and Inflammatory Markers in Children with Autoimmune Thyroiditis(Galenos Publ House, 2023) Tasolar, Sevgi Demiroz; Sigirci, Ahmet; Ciftci, Nurdan; Cengiz, Aslinur; Dogan, Gulec Mert; Akinci, AysehanIntroduction: Although more common in adults, autoimmune thyroiditis (AT) is one of the most common thyroid diseases in children and adolescents. Salivary gland involvement has been described in many studies of patients with AT. Several inflammatory scores are used to assess the inflammatory status of patients with systemic autoimmune diseases. We aimed to sonographically evaluate the parotid and submandibular salivary glands with inflammatory parameters in patients with AT in our study. Methods: Our study population consisted of 37 consecutive pediatric AT patients and 29 healthy control subjects. Ultrasonographic and laboratory evaluations of the study population were performed. Jamovi and MedCalc software were used to analyze the data. Results: The volume of the thyroid gland in the patients was significantly higher than that in the control group (p=0.030), while there was no difference in the volume of the salivary glands. Multiple logistic regression analysis was planned to assess the predictability of salivary gland involvement in patients with the disease. Both systemic immune-inflammation index (SII) and pan-immune inflammation value (PIV) were found to be predictors of salivary gland involvement in AT patients. Conclusion: We found that both SII and PIV inflammatory markers are predictive of salivary gland parenchymal changes in patients with AT, and SII is likely to be more valuable than PIV at this time.Öğe Multi-parameter-based radiological diagnosis of Chiari Malformation using Machine Learning Technology(Wiley-Hindawi, 2021) Tetik, Bora; Dogan, Gulec Mert; Pasahan, Ramazan; Durak, Mehmet Akif; Guldogan, Emek; Sarac, Kaya; Onal, CagatayBackground The known primary radiological diagnosis of Chiari Malformation-I (CM-I) is based on the degree of tonsillar herniation (TH) below the Foramen Magnum (FM). However, recent data also shows the association of such malformation with smaller posterior cranial fossa (PCF) volume and the anatomical issues regarding the Odontoid. This study presents the achieved result regarding some detected potential radiological findings that may aid CM-I diagnosis using several machine learning (ML) algorithms. Materials and Methods Midsagittal T1-weighted MR images were collected in 241 adult patients diagnosed with CM, eleven morphometric measures of the posterior cerebral fossa were performed. Patients whose imaging was performed in the same centre and on the same device were included in the study. By matching age and gender, radiological exams of 100 clinically/radiologically proven symptomatic CM-I cases and 100 healthy controls were assessed. Eleven morphometric measures of the posterior cerebral fossa were examined using 5 designed ML algorithms. Results The mean age of patients was 29.92 +/- 15.03 years. The primary presenting symptoms were headaches (62%). Syringomyelia and retrocurved-odontoid were detected in 34% and 8% of patients, respectively. All of the morphometric measures were significantly different between the groups, except for the distance from the dens axis to the posterior margin of FM. The Radom Forest model is found to have the best 1.0 (14 of 14) ratio of accuracy in regard to 14 different combinations of morphometric features. Conclusion Our study indicates the potential usefulness of ML-guided PCF measurements, other than TH, that may be used to predict and diagnose CM-I accurately. Combining two or three preferable osseous structure-based measurements may increase the accuracy of radiological diagnosis of CM-I.Öğe Nadir Bir Olgu: Ayak Bileğinde Nörotekoma(2021) Dogan, Gulec Mert; Sığırcı, AhmetNörotekomalar veya sinir kılıf miksomaları, periferik sinir kılıfı kaynaklı, benign neoplazilerdir. Bu tümör genellikle deri veya daha az sıklıkta mukozal veya submukozal dokuları tutan ve tipik olarak küçük, soliter, yavaş büyüyen ve kırmızımsı nodül veya papül olarak tanımlanır. Genelde başboyun ve üst ektremitede yerleşim gösterse de; bizim vakamızda olduğu gibi, nadir olarak alt ekstremitede saptanan olgular da mevcuttur. Nörotekoma yirmili yaşlarda daha sık iken; literatürde 10 yaşın altında vaka bildirimi sadece birkaç tanedir. Preoperatif dönemde radyolojik incelemeler, hem nörotekoma tanısını koymak, hem de yeterli cerrahi planlama yapmak açısından önemlidir. Manyetik Rezonans Görüntüleme ile kitlenin yerleşimi ve çevre dokularla ilişkisi değerlendirilebilir. Çocukluk çağı yumuşak doku tümörlerinin ayırıcı tanısında vasküler ve fibröz lezyonlar, nöral tümörler ve yabancı cisim reaksiyonları düşünülmelidir. Tedavisi mümkünse tam cerrahi rezeksiyondur. Eksik rezeksiyonda nadir olarak lokal rekürrensler bildirilmiştir. Biz de ayak bileğinde hemanjiom olarak takip edilen ve histopatolojik olarak nörotekoma tanısı olan olguyu tartışmak istedik.Öğe Neurofibromas of the bladder in a child with neurofibromatosis type 1(Brazilian Soc Urol, 2018) Dogan, Gulec Mert; Sigirci, Ahmet; Karaca, Leyla[Abstract Not Available]Öğe Pediatric renal transplantation; 10 years experience(2021) Okut, Gokalp; Dogan, Gulec Mert; Doğan, Sait MuratObjective: Although renal transplantation (RT) is the first treatment option for children with end-stage renal failure, the number of transplanted children remains low compared to adults. Experience of the individual pediatric transplant center is very important in the prognosis of pediatric transplant recipients. In this study, our pediatric RT experience was presented. Material and Methods: We retrospectively analyzed the data of 27 patients who had RT in our clinic between April 2009 and April 2019. Results: Fifteen of the patients were males, and mean age of all patients was 12.36 ± 4.18 years (range 4-17 years). The most frequent etiology for endstage renal disease (ESRD) was vesicourethral reflux. Eighteen (66.7%) of the transplanted kidneys came from cadaveric donors and 9 (33.3%) from live donors. One patient had preemptive RT and one patient had a re-RT. Twenty-two patients were on peritoneal dialysis program and four patients were on hemodialysis program. Mean dialysis time before transplantation was 29 (3-104) months. Bleeding was the most common surgical complication. Delayed graft function developed in four patients, and all of their grafts were from cadaveric donors. Rejection developed in 12 of our patients, graft loss was observed in only four of them. Considering all patients, graft survival rates were 100% in the 1st and 3rd years, and 92% in the 5th year. Conclusion: Pediatric RT program is difficult to establish, maintain and develop. Complications after transplantation are not uncommon; therefore, early detection and appropriate management are needed. Strategies are still needed to increase post-transplant success.Öğe Surgical complications after pediatric kidney transplantation; Single center experience(2021) Okut, Gokalp; Dogan, Gulec Mert; Dogan, MuratAim: Kidney transplantation is the most effective treatment for end stage renal disease in all age groups. In this study, we analyzed our surgical complications after pediatric kidney transplantation. Materials and Methods: The data of pediatric patients who underwent kidney transplantation in our center between April 2009 and April 2019 were retrospectively analyzed. We divided the complications of the patients requiring secondary surgery into two groups as early and late according to their appearance in the first week and after. Wound problems, local or systemic infections, incisional hernias were not included in the surgical complication group. Results: Among the 27 pediatric kidney transplant procedures performed in our center, there were 11 surgical complications (6% early and 5 late complications) (40%). 4 of the complications in the early transplant period were due to bleeding, 1 was due to the torsion of the vascular structures belonging to the graft, and 1 was due to lymphocele development. Three of the late complications were ureteral stenosis, and two were due to vesicoreteral reflux to the transplant kidney. In our study group, there was no patient loss due to transplantation. Graft loss was not related to surgical complication in any patient. Conclusion: Pediatric kidney transplantation is a procedure that can be safely performed in our center, by looking at our patient and graft survival results and low surgical complications. Immediate identification and treatment of any complications are critical to the graft and patient survival.Öğe Türkiye’de Vergilendirmede Dijital Dönüşüm(2022) Demiroz Tasolar, Sevgi; Sigirci, Ahmet; Dogan, Gulec Mert; Cengiz, Aslinur; Subasi, Vedat; Yildiz, Turan; Tabel, YilmazAim: It is aimed to evaluate the effect of reflux time in primary VUR in terms of predicting endoscopic treatment success and treatment timing in VUR management. Vesicoureteral reflux (VUR) is an important cause of urinary tract infection and chronic renal disease. Voiding cystourethrography (VCUG) is the gold standard diagnostic test in the diagnosis of VUR. In recent years, new parameters related to VCUG have been more objectively studied to evaluate the clinical prognosis. Materials and Methods: In our study, the records and imaging findings of children with primary VUR who underwent VCUG examination between 2012 and 2019, who were treated with endoscopic injections, were retrospectively reviewed. Forty-one children (67 renal units) were included in our study. Patients with preoperative VCUG, urinary ultrasonography, dimercaptosuccinic acid (DMSA) renal scan, and post-operative control VCUG were included in this study. Results: Patients with preoperative VUR grade 1-2 were divided into two groups as “low grade” and patients with stage 3-4-5 as “high grade”. In the general patient pop- ulation, endoscopic success rates in terms of renal unit deficit were found to be 46.3% (31/67). When the subgroup was analyzed, the endoscopic treatment success rate was 72.2% (13/18) in the low-grade group, versus 36.7% (18/49) in the high-grade group (p = 0.010). In the multivariate logistic regression analysis performed to identify indepen- dent predictors of scarring, reflux degree and reflux time were found to be independent predictors of scarring. Conclusion: In our study, we found that in VCUG evaluated preoperatively, VUR time as well as VUR grade were effective on endoscopic success rate and scar development. Based on these results, it could be thought that VUR time may be effective in selecting the best candidates for surgery and in the management and timing of treatment of VUR patients.
