Browsing by Author "Yektas, C"

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    Self-Harm in Children and Adolescents Who Presented at Emergency Units During the COVID-19 Pandemic: An International Retrospective Cohort Study
    Wong, BHC; Cross, S; Zavaleta-Ramirez, P; Bauda, I; Hoffman, P; Ibeziako, P; Nussbaum, L; Berger, GE; Hassanian-Moghaddam, H; Kapornai, K; Mehdi, T; Tolmac, J; Barrett, E; Romaniuk, L; Davico, C; Moghraby, OS; Ostrauskaite, G; Chakrabarti, S; Carucci, S; Sofi, G; Hussain, H; Lloyd, ASK; Mcnicholas, F; Meadowcroft, B; Rao, MN; Csabi, G; Gatica-Bahamonde, G; Ogutlu, H; Skouta, E; Elvins, R; Boege, I; Dahanayake, DMA; Anderluh, M; Chandradasa, M; Girela-Serrano, BM; Uccella, S; Stevanovic, D; Lamberti, M; Piercey, A; Nagy, P; Mehta, VS; Rohanachandra, Y; Li, J; Tufan, AE; Mirza, H; Rozali, F; Baig, BJ; Noor, IM; Fujita, S; Gholami, N; Hangul, Z; Vasileva, A; Salucci, K; Bilac, O; Yektas, C; Cansiz, MA; Aksu, GG; Babatunde, S; Youssef, F; Al-Huseini, S; Kilicaslan, F; Kutuk, MO; Pilecka, I; Bakolis, I; Ougrin, D
    Objective: To compare psychiatric emergencies and self-harm at emergency departments (EDs) 1 year into the pandemic, to early pandemic and pre pandemic, and to examine the changes in the characteristics of self-harm presentations.Method: This retrospective cohort study expanded on the Pandemic-Related Emergency Psychiatric Presentations (PREP-kids) study. Routine record data in March to April of 2019, 2020, and 2021 from 62 EDs in 25 countries were included. ED presentations made by children and adolescents for any mental health reasons were analyzed.Results: Altogether, 8,174 psychiatric presentations were recorded (63.5% female; mean [SD] age, 14.3 [2.6] years), 3,742 of which were self-harm presentations. Rate of psychiatric ED presentations in March to April 2021 was twice as high as in March to April 2020 (incidence rate ratio [IRR], 1.93; 95% CI, 1.60-2.33), and 50% higher than in March to April 2019 (IRR, 1.51; 95% CI, 1.25-1.81). Rate of self-harm presentations doubled between March to April 2020 and March to April 2021 (IRR, 1.98; 95% CI, 1.68-2.34), and was overall 1.7 times higher than in March to April 2019 (IRR, 1.70; 95% CI, 1.44-2.00). Comparing self-harm characteristics in March to April 2021 with March to April 2019, self-harm contributed to a higher proportion of all psychiatric presentations (odds ratio [OR], 1.30; 95% CI, 1.05-1.62), whereas female representation in self-harm presentations doubled (OR, 1.98; 95% CI, 1.45-2.72) and follow-up appointments were offered 4 times as often (OR, 4.46; 95% CI, 2.32-8.58).Conclusion: Increased pediatric ED visits for both self-harm and psychiatric reasons were observed, suggesting potential deterioration in child mental health. Self-harm in girls possibly increased and needs to be prioritized. Clinical services should continue using follow-up appointments to support discharge from EDs.Diversity & Inclusion Statement: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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    Cytokine expression profiles in children and adolescents with tic disorders
    Kutuk, MO; Tufan, AE; Kilicaslan, F; Gokcen, C; Aksu, GG; Yektas, C; Kandemir, H; Celik, F; Mutluer, T; Buber, A; Karadag, M; Coban, N; Coskun, S; Hangul, Z; Altintas, E; Acikbas, U; Giray, A; Aka, Y; Basturk, B; Kutuk, O
    The etiology of tic disorders (TDs) is not precisely known, although several lines of evidence suggest involvement of the immune system in pathogenesis. Here, we aimed to determine the expression levels of pro-inflammatory and anti-inflammatory cytokines in children with TD and compare them with those of healthy controls. Furthermore, we also evaluated their association with clinical variables in the TD group. Within the study period, 88 children with tic disorders and 111 healthy control children were enrolled. Most children with tic disorders were diagnosed with Tourette's disorder (n = 47, 53.4%) or persistent motor tic disorder (n = 39, 44.3%), while the remainder (n = 2, 2.3%) were diagnosed with persistent vocal tic disorder. We found that children with tic disorders had significantly elevated levels of IL-1 beta, TNF-alpha, IL-6 and IL-4 expression, while we detected lower expression levels of IL-17 in children with tic disorders. Our findings provide a molecular landscape of cytokine expression in children with TD, which may suggest a proinflammatory state not affected by the presence of comorbidity and symptom severity. Delineating the contribution of alterations in the immune system to the pathogenesis of tic disorders may pave the way for better therapeutic interventions.
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    Cytokine expression profiles in Autism spectrum disorder: A multi-center study from Turkey
    Kutuk, MO; Tufan, E; Gokcen, C; Kilicaslan, F; Karadag, M; Mutluer, T; Yektas, C; Coban, N; Kandemir, H; Buber, A; Coskun, S; Acikbas, U; Guler, G; Topal, Z; Celik, F; Altintas, E; Giray, A; Aka, Y; Kutuk, O
    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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    Novel inflammatory targets for immunotherapies in pediatric patients with trichotillomania
    Kutuk, MO; Tufan, AE; Kilicaslan, F; Mutluer, T; Gokcen, C; Karadag, M; Yektas, C; Kandemir, H; Buber, A; Aksu, GG; Topal, Z; Giray, A; Celik, F; Acikbas, U; Kutuk, O
    Immune dysregulation may be important in the etiology of obsessive-compulsive and related disordersandbody-focusedrepetitivebehaviors, such as Trichotillomania (TTM). The role of inflammation and inflammatory markers in TTM has received relatively little attention. This study was aimed to determine the expression levels of inflammatory markers (i.e. IL-1 beta, IL-1 alpha, IL-4, IL-6, IL-17, TNF-alpha and TGF-5) in peripheral blood mononuclear cells of children with TTM and healthy controls and to evaluate their association with clinical variables. Seventy-seven patients with TTM and 107 healthy controls were enrolled in the study. Peripheral blood was collected in standardized conditions. The mean age of patients and controls did not differ significantly (10.8 +/- 4.4 and 12.0 +/- 3.2 years; respectively). The majority of patients with TTM and controls were females (n = 55, 71.4 % and n = 55, 51.4 %; respectively); with a greater preponderance of females among TTM. Patients with TTM had significantly elevated expression levels of TNF-alpha, IL-6 and IL-17 compared to controls. However, the expression level of IL-4 was significantly reduced in TTM patients compared to controls. Accordingly, we found a proinflammatory state in TTM and those findings may suggest novel treatment options for TTM and further, crossdisciplinary studies focusing on neuro- inflammation in TTM conducted on larger samples are needed.