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Öğe Could Hemogram Parameters Predict Extensive Pulmonary Involvement in SARS CoV-2 Infection?(2022) Cosgun, Zeliha; Kalfaoğlu, Melike Elif; Dağistan, Emine; Özsari, Emine; Aktaş, GülaliAim: Since the start of the pandemic, the novel coronavirus infection SARS CoV-2 has caused huge morbidity and mortality, as well as a significant economic cost. We aimed to compare clinical and laboratory findings of the SARS CoV-2 patients with mild pulmonary involvement to those in subjects with advanced pulmonary involvement. Material and Methods: In this study, the relationship between hemogram indices and pulmonary involvement in patients hospitalized for SARS CoV-2 infection at Bolu Abant Izzet Baysal University Hospital was investigated. We analyzed the thorax CT images of the subjects with SARS CoV-2 in present retrospective study. Radiological pattern of disease-related in the lungs, percentage of lung involvement, hemogram parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), aspartate and alanine transaminases (AST and ALT), lactate dehydrogenase (LDH), D-dimer, ferritin, total bilirubin, albumin, creatinine kinase, serum creatinine in patients with advanced and mild pulmonary involvement were compared. Results: Advanced pulmonary involvement (greater than 50%) was positively and significantly correlated with ESR, (r=0.32, p<0.001), CRP (r=0.37, p<0.001), LDH (r=0.46, p<0.001), D-dimer (r=0.19, p<0.001), ferritin (r=0.37, p<0.001), mean platelet volume (MPV) (r=0.13, p<0.001), the neutrophil to lymphocyte ratio (NLR) (r=0.33, p<0.001) and platelet to lymphocyte ratio (PLR) (r=0.27, p<0.001). Conclusion: We suggest that MPV, PLR and NLR could be early predictors of advanced pulmonary involvement in SARS CoV-2 patients. Physicians should aware of this complication in the setting of elevated MPV, PLR or NLR levels.Öğe Could serum uric acid to HDL cholesterol ratio predict sacroiliitis?(Public Library Science, 2023) Kalfaoğlu, Melike ElifRecently, several inflammatory markers, including the uric acid to HDL cholesterol ratio (UHR), triglyceride/HDL cholesterol ratio (THR), systemic inflammatory index (SII), and C-reactive protein to albumin ratio (CAR), have been reported to be associated with inflammatory conditions. However, their collective role in sacroiliitis has not been extensively studied. This study aims to investigate the general characteristics and inflammatory markers in patients with and without sacroiliitis, and to observe any differences in these parameters in subjects with active and chronic sacroiliitis. Patient with sacroiliitis who showed up in the Radiology Department of Abant Izzet Baysal University Hospital were enrolled. Patients diagnosed with sacroiliitis based on clinical symptoms, physical examination, and conventional radiography or MRI findings were included in the sacroiliitis group. Patients without sacroiliitis who present with back pain or hip pain but have normal radiographic findings were included in the control group. General characteristics, including age, sex, body mass index (BMI), medical history, and disease duration, were collected from all participants. Blood samples were collected to measure inflammatory markers, including UHR, THR, SII, and CAR. The collected data were compared between sacroiliitis and control groups. Subgroup analysis was also performed to compare the inflammatory markers between subjects with active and chronic sacroiliitis. The median UHR of the sacroiliitis and control subjects were 11% (3-20%) and 7% (3-13%), respectively (p<0.001). Serum UHR was significantly and positively correlated with CRP (r: 0.4, p = 0.001) and ferritin (r: 0.17, p = 0.045) levels. In ROC analysis, a UHR level higher than 8% has an 81% sensitivity and 64% specificity in detecting sacroiliitis (AUC: 0.8, p<0.001, 95% CI: 0.72-0.84). In conclusion, we suggest that UHR could provide useful data as an additional diagnostic tool in patients with sacroiliitis.Öğe The effects of chronic smoking on total cerebral blood volume measured by carotid and vertebral artery doppler ultrasonography(Wiley, 2017) Kalfaoğlu, Melike Elif; Hızal, Mustafa; Kıyan, Aysu; Gürel, KamilPurposeTo evaluate the effects of chronic cigarette smoking on total cerebral blood flow in healthy adults by Doppler ultrasonography (US). MethodsWe evaluated 50 smoker (median age 29) and 50 nonsmoker (median age 28) healthy, 20- to 40-year-old subjects without any cardiovascular and cerebrovascular disease. Peak systolic maximal blood flow velocity (PSV), end-diastolic maximal blood flow velocity (EDV), time-averaged mean blood flow velocity (TAMV), resistance index (RI), and pulsatility index (PI) were measured in the left and right carotid and vertebral arteries, and total cerebral blood flow volume was calculated. ResultsThere was no significant difference of smoking rate between genders. Blood pressure and PSV values were similar in both groups. EDV values of internal carotid artery (ICA) and vertebral artery (VA) were lower and RI and PI values were higher in smokers. TAMV, total ICA (-10.8%) and VA (-6%) flow volume, and tCBF (-9.2%) were lower in smokers. ConclusionsDoppler US is an effective tool to detect tCBF volume decrease in chronic cigarette smokers. Although minimal, this decrease, as demonstrated here in asymptomatic, healthy people, might be critical in patients with subclinical cerebral arterial insufficiency. (c) 2017 Wiley Periodicals, Inc. J Clin Ultrasound45:561-565, 2017Öğe Evaluation of hepatic/renal and splenic/renal echointensity ratio using ultrasonography in diabetic nephropathy(MDPI, 2023) Kalfaoğlu, Melike ElifThe objective of this study is to assess the hepatic/renal and splenic/renal echointensity ratios in ultrasonography in patients with and without diabetic nephropathy. This retrospective study included patients with diabetes mellitus who underwent ultrasound examinations at our hospital between January 2023 and May 2023. Ultrasound examinations were conducted using renal cortical echogenicity and corticomedullary differentiation by using B-mode ultrasonography. The hepatic/renal and splenic/renal echo intensity ratios were compared among study groups (diabetic patients with diabetic nephropathy and without nephropathy). The diabetic nephropathy group exhibited significantly higher right renal echointensity and left renal echointensity compared to the non-nephropathic group. Additionally, the splenic/renal echointensity ratio and hepatic/renal echointensity ratio were significantly lower in the diabetic nephropathy group. Urinary microalbumin levels were significantly correlated with right renal echointensity (r = 0.65, p < 0.001) and left renal echointensity (r = 0.69, p < 0.001). There was also a significant inverse correlation between the urinary albumin and splenic/renal echointensity ratio (r = -0.58, p < 0.001). Ultrasonography, specifically the assessment of hepatic/renal and splenic/renal echointensity ratios, shows promise as a noninvasive and cost-effective method for evaluating morphological changes in the kidneys in patients with diabetic nephropathy. These findings suggest that ultrasonography can be a valuable tool for monitoring the progression of diabetic nephropathy and contributing to its early detection and management.Öğe İdiyopatik Normal Basınçlı Hidrosefali Tanısı ile Şant Uygulanan Hastaların Tedavi ve Gözlem Sonuçları(2021) Şenol, Özgür; Dağistan, Emine; Cosgun, Zeliha; Kalfaoğlu, Melike Elif; Dağistan, YaşarAmaç İdiyopatik normal basınçlı hidrosefali (iNPH) tanısı ile orta basınçlı ventriküloperitoneal (VP) ve lumboperitoneal (LP) şant uygulanan hastaların 3 yıllık takip sırasında klinik sonuçları ve şant tedavisinde karşılaştığımız problemleri sunmayı amaçladık. Gereç ve Yöntem Çalışmaya 2013 – 2017 tarihleri arasında Nöroloji ve Nöroşirurji Anabilim Dallarına başvuran, klinik ve radyolojik olarak iNPH olarak değerlendirilen hastalar retrospektif olarak tarandı.VP ve LP şant uygulanan hastalarda başarı oranları ve komplikasyonları kayıt edildi. Bulgular Değerlendirilen 26 hastanın 19 tanesine (%73,1) VP şant, 7 tanesine (%26,9) LP şant uygulandı. 5 hastaya (%19) batın revizyonu, 2 hastaya (%11) kranial revizyonu uygulandı. Cerrahi sonrası 1 hastada (%5) subdural hematom gelişti. 3 (%11) hastada analjezik tedaviye yanıtlı, günler içerisinde düzelen baş ağrısı gelişti. Hiçbir hastada şant enfeksiyonu, şant erezyonu, işitme kaybı, görme kaybı veya sistemik enfeksiyon gibi majör komplikasyon görülmedi. Sonuç iNBH’de hastaların yaş ortalaması yüksek olmasından dolayı beyin atrofiside eşlik edebileceğinden hızlı beyin omurilik sıvısı (BOS)boşalımının kanamalara sebep olma riski göz önünde bulundurulmalıdır. Komplikasyon oranının daha düşük olması ve ayarlanabilir şantın manyetik ortamlardan çabuk etkilenmesinden dolayı öncelikle orta basınçlı VP şant ve ardından LP şant düşünülebilirÖğe Kronik sigara içicisi 20-40 yaş arası sağlıklı populasyonda sigaranın toplam beyin kan akım hacmine etkisinin Doppler ultrasonografi ile değerlendirilmesi(Bolu Abant İzzet Baysal Üniversitesi, 2009) Kalfaoğlu, Melike Elif; Gürel, KamilKronik sigara içicisi 20-40 yaş arası sağlıklı populasyonda sigaranın toplam beyin kan akım hacmine etkisinin Doppler ultrasonografi ile değerlendirilmesiBu çalışmanın amacı genç ve sağlıklı bireylerde 5 yıldan uzun süre sigara kullanımının toplam beyin kan akım hacmine etkisinin olup olmadığının Doppler ultrasonografi ile değerlendirilmesidir.Çalışmaya 20-40 yaş arası 5-20 paket/yıl sigara kullanan 50 kişi ile kontrol grubu olarak sigara kullanmayan 50 kişi olmak üzere, toplam 100 olgu (45'i erkek 55'i kadın) dahil edildi. Olguların hepsinde pik sistolik hız, diyastol sonu hız, ortalama kan akım hızı, pulsatilite indeksi, resistivite indeksi, her iki internal karotid arter ve vertebral arterlerde kan akım hacimleri ve toplam beyin kan akım hacmi hesaplandı. İstatistiksel değerlendirmeler ortalama, standart sapma, lineer regresyon analizi, ?Student's t testi?, ?Mann-Whitney U? testi ve ?Pearson korelasyon testi? kullanılarak yapıldı. p değerinin 0.05'ten küçük olması anlamlı kabul edildi.Her iki grup arasında pik sistolik hız değerlerinde anlamlı farklılık yoktu (p > 0.05). Sigara kullanan grupta diastol sonu hız ve ortalama kan akım hızı değerleri daha düşük; pulsatilite ve rezistivite indeks değerleri daha yüksek bulundu (p < 0.001). Toplam beyin kan akım hacmi her iki grupta da fizyolojik sınırlarda olmakla birlikte, sigara kullananlarda (661,1 ± 21,2 ml/dk), kullanmayan olgulardan (728,1 ± 26,8 ml/dk) ortalama %9.2 oranında daha düşüktü (p < 0.001). Regresyon analizinde paket/yıl sayısında artmanın toplam beyin kan akım hacmini anlamlı derecede azalttığı saptandı (p < 0.001), güven aralığı ([-7,698] ? [-5,607]).Kronik sigara kullanımı toplam beyin kan akım hacminde azalmaya neden olmaktadır.Öğe Methanol Intoxication in the Differential Diagnosis of COVID-19(2022) Afşin, Emine; Küçük, Furkan; Kalfaoğlu, Melike ElifAlthough central nervous system findings are promi nent in methanol intoxication, the lungs are also affected. There have been several studies in literature describing autopsy-based lung findings, while there have been no clinical cases reported on to date. We present here a case identified radiologically as pul monary edema that was included in the differential diagnosis of COVID-19.Öğe Relationship between osteoarthritis findings in knee radiography and meniscus lesionin magnetic resonance imaging in symptomatic knee pain cases(2021) Kalfaoğlu, Melike Elif; Cosgun, Zeliha; Dağistan, EmineAim: Knee osteoarthritis is a very common joint disease in the community. However, some meniscus lesions are asymptomatic. Studies show that a significant number of individuals with knee pain without radiographic osteoarthritis findings show meniscus injury on magnetic resonance imaging (MRI). Our study aimed to evaluate the relationship between meniscus lesions and the presence of radiographic knee osteoarthritis in individuals over 50 years of age with knee pain complaints. Methods: Radiographic and MRI results of two hundred and forty patients who applied to our hospital with the complaint of knee pain between August 2018 and January 2020 were analyzed. Radiographic grading for knee osteoarthritis was performed using the Kellgren Lawrence scale. Classification of meniscus lesions in MRI was made as per the criteria defined by the British Knee Meniscus Surgery Association. Intergroup results were evaluated statistically. Results: Osteoarthritis was detected in 110 (45.8%) of 240 knee radiographs. In 78.3% of all cases, meniscus lesions were detected in 96.4% of those with osteoarthritis and 63% of those without osteoarthritis. In patients with osteoarthritis, the prevalence of surgically targeted and possible target lesions was found to be significantly higher than those with no arthritis findings. Conclusions: According to our study results, meniscus lesions were found quite common in individuals with knee pain, especially those with osteoarthritis. Particularly in patients with radiographic osteoarthritis findings, surgical targets and possible target meniscus lesions were more common than those without osteoarthritis findings. Therefore, MRI, in addition to direct radiography, should not be overlooked when determining treatment.Öğe Two maxillary lesions containing bony/calcified shells(British Inst Radiology, 2009) Gürel, Kamil; Sanal, S. K.; Gürel, Safiye; Kalfaoğlu, Melike Elif; Boran, ÇetinBecause of the close anatomical relationship between the maxillary sinus and the adjacent dental region, determining the primary site of cysts in these regions can be a diagnostic dilemma. In this article, two cases with similar radiological findings are presented. These cases had lesions involving the maxillary sinus and the adjacent alveolar process; the lesions were surrounded with egg-shaped, linear opacities. Diagnoses of a residual radicular cyst in one case and a calcified mucocoele (which is very rare) in the other case were predicted with the help of radiological findings and were confirmed surgically and histopathologically. Dentomaxillofacial Radiology (2009) 38, 296-300. doi: 10.1259/dmfr/33360963
