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    Cytokine expression profiles in Autism spectrum disorder: A multi-center study from Turkey
    (Academic Press Ltd- Elsevier Science Ltd, 2020) Kutuk, Meryem Ozlem; Tufan, Evren; Gokcen, Cem; Kilicaslan, Fethiye; Karadag, Mehmet; Mutluer, Tuba; Acikbas, Ufuk
    Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by impairments in communication and social interaction as well as restricted interests and repetitive behaviors. The pathogenesis of ASD is not completely understood, but a growing body of research has demonstrated that the immune response may be a contributing factor in the etiology and/or ontogeny of ASD. The aim of this study was to determine the expression levels of IL-1 beta, IL-1 alpha, IL-4, IL-6, IL-17, TNF-alpha and TGF-beta in peripheral blood mononuclear cells of children with ASD and healthy controls in order to determine the contributions of cytokines to ASD. Within the study timeframe, 195 children with ASDs (80.5% male) and 162 controls (73.6% male) were enrolled. Most children with ASD had a comorbid disorder (n = 114, 58.5%), with the most common diagnoses as Intellectual Developmental Disorder (IDD, n = 64, 32.8%) and ADHD (n = 64, 32.8%). The majority of children with ASD had severe autistic symptoms as evaluated via Childhood Autism Rating Scale (CARS, n = 130, 64.6%). The mean CARS score in the ASD sample was 40.8 (S.D. = 7.6). The patients with ASD were found to have significantly higher levels of IL-6 (p < 0.001) and significantly lower levels of IL-17 (p < 0.05, all Bonferroni corrected). Treatment tended to affect IL-4 levels. Lastly, discriminant function analysis (DFA) revealed that a combination of IL-6, IL-17 and IL-1 alpha correctly classified 56.6% of cases. Despite extensive immunological evidence suggesting immune system aberrations, further research is required to clarify the relationship between immune profiles and ASD symptoms.
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    Reply to Letter to the Editor-Treatment of Hepatic Hydatid Disease-Role of Surgery, ERCP, and Percutaneous Drainage: A Retrospective Study
    (Lippincott Williams & Wilkins, 2021) Muhammedoglu, Bahtiyar; Pircanoglu, Eyup M.; Piskin, Erol; Torun, Serkan; Karadag, Mehmet; Topuz, Sezgin; Koktas, Suleyman
    [Abstract Not Available]
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    Smartphone evaluation of postero-anterior chest x-rays: An inter-observer study
    (W B Saunders Co-Elsevier Inc, 2021) Bogan, Mustafa; Altinsoy, Hasan Baki; Karadag, Mehmet
    Background: Posterior-anterior chest x-ray (PA-CXR) is among the most commonly used imaging methods in the diagnosis both in the emergency departments (ED) and the other clinics. The aim of the present study was to evaluate the diagnostic reliability of PA-CXRs sent via a smartphone. Methods: This study was conducted as an inter-observer study. PA-CXRs were photographed with a smartphone and they were sent to two separate participants (emergency medicine specialists one with 4 years experience and another with 3) via the WhatsApp application. And the participants evaluated to these images on their mobile phone. Results: A poor concordance was determined in a ratio of 3/8 and good concordance was detected in a ratio of 3/8 between the two participants (p < 0.05). It was observed that only the mediastinum assessments could be an alternative to the gold standard (p < 0.01). Conclusion: We may conclude that the assessments done via a smartphone (photographing and sharing) may not be reliable. (C) 2020 Elsevier Inc. All rights reserved.
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    Treatment of Hepatic Hydatid Disease: Role of Surgery, ERCP, and Percutaneous Drainage: A Retrospective Study
    (Lippincott Williams & Wilkins, 2021) Muhammedoglu, Bahtiyar; Pircanoglu, Eyup Mehmet; Piskin, Erol; Torun, Serkan; Karadag, Mehmet; Topuz, Sezgin; Koktas, Suleyman
    Introduction: Failure to follow the World Health Organization's Informal Working Group on Echinococcosis guidance or having limited experience in the management of cystic echinococcosis (CE) in endemic or nonendemic areas of the world may lead to risky unnecessary procedures. Materials and Methods: Medical records of all patients undergoing surgery for hepatic hydatid disease at the gastroenterologic surgery and general surgery departments of our hospital between December 2014 and October 2019 were collected and reviewed retrospectively. Demographic characteristics, the size and number of the cysts preoperative liver function tests, surgical treatment, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous drainage (PD), morbidity, and treatment outcomes were reviewed. Results: Of 122 patients included in the study, 77 (63, 1%) were female and 45 (36, 9%) were male individuals and their mean age was 44.95 years. CE1 was identified in 13 patients (10.6%) CE2 in 66 patients (54.1%), CE3a in 7 patients (5.8%), CE3b in 28 patients (22.9%), and CE4 in 8 patients (6.6%). Twenty patients (16.4%) with a cystobiliary fistula in the liver, obstructive jaundice, and postoperative bile leak underwent ERCP. PD was performed in patients with fluid in the hepatic hydatid cyst pouch, increased pouch size because of bile collection, and clinical symptoms postoperatively. Patients presenting with persistent bile leak despite PD underwent ERCP and were treated with endoscopic sphincterotomy and stent placement. Patients with PD were followed by keeping the percutaneous drain open and closed for a while to create pressure difference in the cyst pouch after ERCP. The percutaneous drain was removed in the next 14 to 21 days after checking the pouch size, whereas the common bile duct stents were removed 2 months later after performing a follow-up cholangiography. Conclusions: ERCP should be the primary method for the diagnosis and treatment for hepatic hydatid cysts ruptured into the ducts. In some cases, high-flow hydatid cysts with rupture into the bile ducts or persistent biliary fistulas can be treated with ERCP and endoscopic sphincterotomy, biliary stent, PD, and nasobiliary drainage without the need for surgical intervention.
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    Using Smartphone to Evaluate Cranial Computed Tomography Videos: An Inter-Observer Study
    (Duzce Univ, Fac Medicine, 2022) Naldemir, Ibrahim Feyyaz; Karaman, Ahmet Kursat; Altinsoy, Hasan Baki; Bogan, Mustafa; Karadag, Mehmet
    Objective: Many clinicians receive Cranial Computed Tomography (CCT) images or videos by their smartphone. The aim of this study was to evaluate the reliability of the CCT videos that are shared through smartphone in the diagnosis. Methods: The CCT videos that were sent via WhatsApp were examined in 9 sections: soft tissue, bone structure, parenchyma, ventricle, vascular structures, middle ear, orbits, sinuses and the extra axial space. Results: The CCT videos were analyzed in 9 sections; there was a perfect agreement among specialists in one of these sections, good agreement in 6 and poor agreement in 2. When compared with the gold standard, it was shown that 5 out of 9 sections could be an alternative to the gold standard. Conclusions: It may be thought that evaluation of the CCT videos can be obtained with messenger applications such as WhatsApp, which is a cheap, fast and common application. But this study shows that diagnostic images and videos shared through the smartphone by a messenger application can not be an alternative to standard evaluations.