Bilal Yildiz

Eskisehir Osmangazi University, Eskişehir, Eskisehir, Turkey

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Publications (21)23.38 Total impact

  • Turkish Journal of Pediatric Disease. 12/2013; 7(4):173-177.
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    ABSTRACT: Accurate diagnosis and early treatment of urinary tract infections (UTI) are important because of its association with renal scarring (RS). To investigate the serum levels of fibronectin, high sensitive CRP (Hs-CRP), urinary fibronectin, and beta-2 microglobulin (beta2MG) levels in patients with UTI and relationship of these parameters with VUR (vesicoureteral reflex) and RS. 72 patients were included in study and divided into three groups: Group I (20 patients with first UTI); Group II (16 patients with recurrent UTI with VUR); Group III (16 patients without UTI with VUR). Serum and urine fibronectin levels were similar in all study groups and controls. Urinary beta2MG levels were higher in Group II (302±179 ng/ml) than in the Group I (134±90 ng/ml) (p < 0.001). Moreover, beta2MG levels were similar in Group II (302±179 ng/ml) and group III (218±147 ng/ml). By contrast, beta2MG levels were higher in Group III (218±147 ng/ml) than in the controls (64±32 ng/ml) (p < 0.001). Hs-CRP levels were higher in Group I (1.8±2.7 mg/L), Group II (23.1±32 mg/L), and III (0.4±0.1 mg/L) than the controls (0.2±0.08 mg/L) (p < 0.001). Hs-CRP levels were higher in Group II (23.1±31.9 mg/L) than in the Group I (1.8±2.7 mg/L) (p < 0.001). Hs-CRP levels were higher in Group I (1.8±2.7 mg/L) and Group II (23.1±31.9 mg/L) than in the Group III (0.4±0.1 mg/L) (p < 0.001). Hs-CRP levels were higher in group III (0.37±0.17 mg/L) than in the controls (0.2±0.08 mg/L) (p < 0.001). Hs-CRP (18.8±25 mg/L) and beta2MG levels (349.4±128.5 ng/ml) were different in UTI with RS from the controls (0.2±0.08 mg/L and 64±32 ng/ml respectively, p < 0.001). Fibronectin levels were similar in patients with and without RS. Increased urinary beta2MG and Hs-CRP were observed in initial UTI and recurrent UTI with VUR. Fibronectin levels were not useful for detection of first and recurrent UTI with VUR and RS. Elevated Hs-CRP levels can help us predetermine the patients with VUR prone to proceed to clinical chronic renal failure.
    European review for medical and pharmacological sciences 10/2013; 17(19):2598-604. · 1.09 Impact Factor
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    ABSTRACT: We present a hypertensive child with a co-existence of polyarteritis nodosa, anti-phospholipid antibodies (aPL), methylenetetrahydrofolate reductase (MTHFR) mutation and increased lipoprotein a level. Elevated renin, aldosterone and aPL levels, micro-aneurysms, occlusion and thrombosis at left and right renal artery were found. Anti-hypertensive agents, prednisolone and pulse cyclophosphamide therapy were started and a stent was inserted in the left renal artery. Two months later, brain magnetic resonance imaging/magnetic resonance imaging angiography showed acute infarct area of the left parietofrontal lobe and middle cerebral artery stenosis. We found bilateral peripheral neuropathy, persistent aPL and elevated Lp(a) level and heterozygous A1298C/MTHFR mutation. Intravenous immunoglobulin and low-molecular-weight heparin treatment was added. In conclusion, our observation suggests that in patients with systemic vasculitis, such as polyarteritis nodosa, aPL are probably associated with greater thrombotic risks. The investigation of the LP(a) levels and MTHFR mutations as a synergic pro-coagulant effect might also be considered for determining patients with vasculitis at risk for severe thrombotic events.
    Pediatrics International 08/2013; 55(4):e107-10. · 0.88 Impact Factor
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    ABSTRACT: Background and methodsSoluble-lymphocyte subsets (sCD19 + CD23+ B cells and sCD4 + CD25+ T cells), soluble-adhesion molecules (sE-selectin) and interleukin-12 (sIL-12) were assayed to evaluate the pathogenesis of steroid sensitive nephrotic syndrome in 48 patients diagnosed with steroid sensitive nephrotic syndrome (SSNS) in active (AS) and remission stages (RS). The ratios of soluble CD19 and sCD19 + CD23 increased in patients with AS with respect to the patients with RS and controls (p < 0.05). Increased sCD19 + CD23 ratios were preserved in the patients with RS when compared with the controls (p < 0.05). Moreover, the ratios of sCD4 + CD25 lymphocyte subsets were not significantly different among the groups. Similarly, serum sIL-12 levels were not considerably disparate between the AS and RS. Serum sE-selectin levels were higher in the patients with AS relative to the controls (p < 0.01) and RS (p < 0.05). No significant correlations were noted between sE-selectin and lymphocyte subset ratios, serum sIL-12 and immunoglobulin levels. There was a positive correlation between sE-selectin, triglyceride (r = 0.757, p < 0.0001) and cholesterol (r = 0.824, p < 0.0001) levels in patients with the AS. The present results indicate that the patients with SSNS appear to have abnormalities in sCD23 + CD19+ cells, defect in T regulatory cell activity, and injury in endothelial cells as indicated by the presence high sE-selectin. These abnormalities might play a role in the pathogenesis of nephrotic syndrome. sIL-12 seems to have no role in pathogenesis of nephrotic syndrome reflecting normal Th1 response.
    Italian Journal of Pediatrics 07/2013; 39(1):42. · 1.34 Impact Factor
  • Nuran Cetin, Bilal Yildiz, Nurdan Kural
    Iranian journal of kidney diseases 07/2013; 7(4):326-7. · 0.94 Impact Factor
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    ABSTRACT: Serum lipids/lipoproteins were assayed to evaluate the diagnostic values of serum lipids/ lipoproteins in neonatal late onset sepsis (NLS) in 36 episodes of NLS (15 of the 36 in preterm newborns and 21 of the 36 in term newborns) while 36 healthy newborns were used as controls. On d 0, levels of total cholesterol (TC), triglyceride (TG), lipoprotein-a (Lp-a), high-density lipoprotein (HDL) and apolipoprotein-A (Apo-A) and B (Apo-B) were found to be significantly lower in the NLS group than in the control group (p=0.001). The sensitivity and specificity values were 61.5% and 69.4% for TC, 96.2% and 44.4% for HDL, 73% and 50% for Lp-a, 69.2% and 83.3% for triglyceride, 73% and 97.2% for Apo-A and 77% and 69.4% for Apo-B, respectively, at diagnosis. In conclusion, Apo-A appeared to be a useful marker for detection of NLS. Low TG levels may be due to impaired triglyceride-related neutralization of lipopolysaccharides in NLS.
    Scandinavian Journal of Infectious Diseases 03/2009; 41(4):263-7. · 1.71 Impact Factor
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    ABSTRACT: Henoch-Schönlein purpura (HSP) is a common systemic vasculitis of childhood, and may affect the kidney. Endothelial cell dysfunction and fibrosis is an important part of HSP vasculitis and may account for renal involvement in HSP. Insulin-like growth factor (IGF)-1 enhances the cytokine-induced expression of adhesion molecules in endothelial cells (EC). Besides, IGF-1 may stimulate angiogenesis, fibrosis and tubular formation in EC and IGF-1 increases glomerular filtration rate. We, therefore, investigated the role of IGF-1 and IGF-binding protein-3 (IGFBP-3) in HSP. The study included 44 patients with HSP (30 boys and 14 girls), including 13 patients with proteinuria, 15 patients with hematuria and 16 patients with positive stool occult blood (SOB), and 26 healthy children. Serum levels of IGF-1 and IGFBP-3 levels were significantly higher in HSP than in the controls (147.9 +/- 121.6 vs 95.7 +/- 67.8 ng/ml, p = 0.024 and 4.4 +/- 2.2 vs 2.3 +/- 0.9 microg/ml, p = 0.001, respectively). Serum IGF-1 levels were significantly higher in HSP with proteinuria than those without proteinuria and controls (p = 0.001 and p = 0.001, respectively). Also, IGFBP-3 levels were greater in HSP with proteinuria compared to those without proteinuria and controls (p = 0.005 and p = 0.0001). Serum immunoglobulin-A/complement-C3 ratio was higher in HSP than in the controls (p = 0.0001) but this ratio did not change according to proteinuria, hematuria or positive SOB. In conclusion, IGF-1 and IGFBP-3 levels could be new markers for determination of renal involvement in HSP.
    The Tohoku Journal of Experimental Medicine 05/2008; 214(4):333-40. · 1.37 Impact Factor
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    ABSTRACT: Mechanisms of compensatory renal growth (CRG) still remain a mystery. Various growth factors, including growth hormone, insulin-like growth factor-1 (IGF-1) have been implicated in different forms of CRG. To investigate the serum levels of IGF-1, vascular endothelial growth factor (VEGF - role in vascular remodelling), matrix metalloproteinase-9 (MMP-9 - essential for normal nephrogenesis) and correlation of renal function in patients with unilateral nephrectomized, agenesis and hypoplasic kidney. Thirty patients were included in this study. In group I, there were 10 patients with unilateral nephrectomy, while in group II, there were 10 patients with unilateral agenesis. As for group III, there were 10 patients with unilateral hypoplastic kidney. The serum levels of IGF-1, IGF-binding protein-3 (IGFBP-3), VEGF and MMP-9 were studied in all the cases. Clearance of creatinin (Ccr) and protein excretion were examined in the 24 h urine. CRG was determined with ultrasonography and scintigraphy. Twenty-six control subjects were also studied. The levels of IGF-1, IGFBP-3, VEGF and MMP-9 were significantly higher in patients than in the control subjects (P < 0.001). Ccr and protein excretion levels were different in study groups than in those of the control group (P < 0.01). There were positive correlations between the serum levels of IGF-1 with IGFBP-3; IGF-1 with MMP-9; IGFBP-3 with MMP-9 (r = 0.825, P = 0.0001; P < 0.001 r = 0.611; P < 0.001 r = 0.585, respectively). There were negative correlations between GFR and the serum levels of IGF-1, IGFBP-3 and MMP-9 (P < 0.01 r = -0.708; P = 0.002 r = -0.803; P < 0.05 r = -0.442, respectively). Furthermore, there were positive correlations between proteinuria and the serum levels of IGF-1, IGFBP-3 and MMP-9 (P = 0.039 r = 0.600; P < 0.05 r = 0.456; P < 0.05 r = 0.424). Increased IGF-1, IGFBP-3, VEGF and MMP-9 were observed in CRG in the follow-up period. IGF-1 and MMP-9 seemed to have increased in patients with CRG in defiance of the development of fibrosis. Moreover, IGF-1 and MMP-9 seem to be associated with reduced renal function and proteinuria.
    Clinical physiology and functional imaging 03/2008; 28(2):107-12. · 1.20 Impact Factor
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    ABSTRACT: Convulsive status epilepticus (CSE) may end fatally or leave serious sequelae. CSE treatment, invariably an emergency case, is based upon i.v. benzodiazepines as well as phenytoin, barbiturates or both. The present paper reports efficiency of lidocaine in CSE. The effects of lidocaine on patients with CSE due to infectious and non-infectious reasons were compared. Lidocaine was given in 29 episodes of CSE to 49 patients having failed to respond to first-line anticonvulsive drugs, such as diazepam, phenobarbital and phenytoin therapy. Lidocaine was given in doses of 2 mg/kg bolus i.v., and then in 4 mg/kg per h infusion. Mean duration of lidocaine infusion was 14.6 +/- 7.8 h. Effectiveness of lidocaine in patients with CSE was found to be 44.4%. Also, 11 patients responded to a single dose of lidocaine (37.9%), while another two (6.9%) required another dose to suppress their seizures. Patients with seizures attributable to infections were observed to have responded favorably to lidocaine when compared to those with seizures due to epilepsy (37.9% vs 6.8%; P < 0.05). Subsequent epilepsy was found to occur more frequently in patients with a poor response to lidocaine than in patients with a good response (P < 0.05). Adverse reactions to lidocaine were observed in three patients (10.3%), two of them having ventricular arrhythmia. As for the other patient, the focal seizure developed into a generalized one. Lidocaine seems to be useful for the management of CSE as a rapid-acting anticonvulsant, particularly in patients with CSE due to infections. But further studies with larger number of patients are needed.
    Pediatrics International 02/2008; 50(1):35-9. · 0.88 Impact Factor
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    ABSTRACT: Sepsis is an important cause of mortality in newborns. However, a single reliable marker is not available for the diagnosis of neonatal late-onset sepsis (NLS). The aim of this study is to evaluate the value of serum amyloid A (SAA) and procalcitonin (PCT) in the diagnosis and follow-up of NLS. 36 septic and healthy newborns were included in the study. However, SAA, PCT, TNF-alpha, IL-1beta, and CRP were serially measured on days 0, 4, and 8 in the patients and once in the controls. Töllner's sepsis score (TSS) was calculated for each patient. CRP, PCT, and TNF-alpha levels in septic neonates at each study day were significantly higher than in the controls (P = .001). SAA and IL-1beta levels did not differ from healthy neonates. The sensitivity and specificity were 86.8% and 97.2% for PCT, 83.3% and 80.6% for TNF-alpha, 75% and 44.4% for SAA on day 0. Present study suggests that CRP seems to be the most helpful indicator and PCT and TNF-alpha may be useful markers for the early diagnosis of NLS. However, SAA, IL-1beta, and TSS are not reliable markers for the diagnosis and follow-up of NLS.
    Mediators of Inflammation 02/2008; 2008:737141. · 3.88 Impact Factor
  • Tohoku Journal of Experimental Medicine - TOHOKU J EXP MED. 01/2008; 214(4):333-340.
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    ABSTRACT: To determine the resistance of antibiotics for complicated urinary tract infection (UTI), including urinary tract anomaly (UTA), for empirical antibiotic therapy of complicated UTI. Four hundred and twenty urine isolates were obtained from 113 patients with recurrent UTI, who used prophylactic antibiotics between February 1999 and November 2004 in the Eskisehir Osmangazi University, Eskisehir, Turkey. Reflux was found to be the most important predisposing factor for recurrent UTI (31.9%). Renal scar was detected more in patients with UTA than without UTA (59.2% versus 12.4%, p<0.05). Gram-negative organisms were dominant in patients with and without UTA (91.5% and 79.2%). Enterococci and Candida spp. were more prevalent in children with UTA than without UTA (p<0.001). Isolates were significantly more resistant to ampicillin, trimethoprim-sulfamethoxazole, amikacin, co-amoxiclav, ticarcillin-clavulanate, and piperacillin-tazobactam in patients with UTA than without UTA. We found low resistance to ciprofloxacin and nitrofurantoin in UTI with and without UTA. Enterococci spp. was highly resistance to ampicillin and amikacin in patients with UTA. Aztreonam, meropenem, and ciprofloxacin seemed to be the best choice for treatment of UTI with UTA due to Escherichia coli and Klebsiella spp. Nitrofurantoin and nalidixic acid may be first choice antibiotics for prophylaxis in UTI with and without UTA. The UTI with UTA caused by Enterococci spp. might not benefit from a combination of amikacin and ampicillin, it could be treated with glycopeptides.
    Saudi medical journal 12/2007; 28(12):1850-4. · 0.62 Impact Factor
  • Bilal Yildiz, Nurdan Kural
    European Journal of Pediatrics 12/2007; 166(11):1179-80. · 1.98 Impact Factor
  • European Journal of Paediatric Neurology - EUR J PAEDIATR NEUROL. 01/2007; 11:96-96.
  • World Allergy Organization Journal 01/2007;
  • Pediatrics International 11/2006; 48(5):493-4. · 0.88 Impact Factor
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    ABSTRACT: We report a 9-month-old boy with major features of Neuhauser syndrome, including megalocornea, mental motor retardation, hypotonia, dysmorphic findings (high-arched palate, broad nasal bridge, epicanthus), who also had additional findings such as Peters' anomaly, microcephaly, undescended testicle, patent ductus arteriosus and atrial septal defects. Ophthalmologic examination demonstrated central opacity of the left cornea and lens and iris adhesions extending from the pupillary margin to the borders of the opacity. Keratoplasty operation was done for the right eye owing to central corneal opacity. Neuhauser syndrome should be considered in the differential diagnosis of the patients with megalocornea, hypotonia and mental and motor retardation who have dysmorphic findings. To the best of our knowledge, Peters' anomaly has not been reported in Neuhauser syndrome previously.
    Clinical Dysmorphology 11/2006; 15(4):249-51. · 0.38 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the immunologic parameters and the effects of glucocorticoid treatment, the absolute numbers of CD4+/CD25+ T lymphocytes, eosinophil counts, levels of eosinophilic cationic protein (ECP), and interleukin (IL)-5 in peripheral blood of patients having acute asthma exacerbations and healthy children were investigated. Samples for the absolute numbers CD4+/CD25+ T lymphocyte and eosinophil count, ECP, and IL-5 were obtained before (day 1) and after (day 5) glucocorticoid treatment. Forced expiratory volume in 1 second and peak expiratory flow rate were measured on days 1 and 5 in asthma patients (n = 25) and in the control group (n = 15). The absolute numbers of CD4+/CD25+ T lymphocyte and eosinophils, levels of ECP, and IL-5 were significantly greater, while forced expiratory volume in 1 second and peak expiratory flow rate were significantly less in the patients with asthma than in the control subjects on day 1. These parameters normalized after glucocorticoid treatment with clinical improvement by day 5. Glucocorticoid treatment is associated with clinical and laboratory improvement achieved in patients with acute asthma exacerbations.
    Allergy and Asthma Proceedings 01/2006; 27(4):371-7. · 2.19 Impact Factor
  • Bilal Yildiz, Nurdan Kural, Coskun Yarar
    Pediatric Nephrology 09/2004; 19(8):943-4; author reply 945. · 2.94 Impact Factor
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    ABSTRACT: A 16-month-old boy was admitted to the clinic because of vomiting and growth failure. His weight and height measurements were under the fifth percentile. He had fair hair and skin, enlarged wrists and rachitic rosaries. The presence of metabolic alkalosis, hypokalemia, hypochloremia, and high renin and aldosterone levels were suggestive of Bartter syndrome. However, in view of the growth failure, fair hair and skin, proteinuria, polyuria and active rickets, cystinosis was considered. Bone marrow smear examination was normal, despite the existence of suspicious crystals in the cornea. Cystine crystals were seen in the conjunctiva biopsy and increased leukocyte cystine level was measured; therefore, definitive cystinosis diagnosis was made. Renal Fanconi syndrome with metabolic acidosis is prominent in cystinosis; however, in rare instances, if sodium-dependent trans-tubular transport defect is present, patients could have Bartter syndrome findings such as hypochloremic metabolic alkalosis. Our case is a good example demonstrating that metabolic alkalosis should not exclude cystinosis and the other signs and symptoms of the patient should be thoroughly evaluated.
    The Turkish journal of pediatrics 48(3):260-2. · 0.56 Impact Factor