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    COVID-19 computed tomography reporting systems: inter- rater and inter-system agreement study
    (2021) Koc, Ural; Unal, Ozlem; Ozkan, Erdem; Kayaaslan, Bircan
    Aim: The aim of this study was to investigate agreements between COVID-19 reporting systems and radiologists. Materials and Methods: A total of 100 laboratory-confirmed COVID-19 cases (49 males, 51 females; age range 19-88 years) were retrospectively collected. Firstly, computed tomography (CT) images were evaluated by two radiologists independently and blinded to clinical notes and laboratory and radiological reports and they gave their impressions independently according to four COVID-19 reporting systems, then all CTs were interpreted again by the two radiologists for extracting CT features at the same session by consensus. Results: Bilateral, lower lobe, peripheral, dorsal and multifocal lung involvements were predominantly seen, and ground-glass opacities (GGOs) were the most common CT imaging finding in the current study. Reporting systems showed fair to moderate agreements between senior and junior raters (0.246-0.490, p<0.001). According to the assigned three-category coding system as similar to that of the Radiological Society of North America (RSNA) Expert Consensus Statement on Reporting and other reporting systems and guidance, strength of inter-rater agreement values was increased (0.365-0.576, p<0.001) and inter-system agreements were substantial to almost perfect in both raters. Conclusion: Radiology reporting including frequently seen CT features and lung parenchyma distributions with systems based on fewer categories may provide good agreement between observers in patients with suspected COVID-19.
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    EEG and MRI findings and their relation with intellectual disability in pervasive developmental disorders
    (Zhejiang Univ Press, 2009) Unal, Ozlem; Ozcan, Ozlem; Oner, Ozguer; Akcakin, Melda; Aysev, Ayla; Deda, Guelhis
    Background. The diagnostic category pervasive developmental disorders (PDDs) refer to a group of five disorders: autism, Rett syndrome, childhood disintegrative disorder, Asperger syndrome, and pervasive developmental disorder not otherwise specified (PDD-NOS). EEG abnormalities and seizures are considered much frequent in autistic subjects with comorbid intellectual disability (ID). In this study, we aimed to evaluate the EEG and MRI findings and their relation with ID in pervasive developmental disorder. Methods: A retrospective, cross-sectional and non-experimental study was performed. Subjects included 81 patients diagnosed with autism or PDD-NOS according to the DSM-IV criteria. The age range of the patients was 2-15 years (mean 6.6 years, SD 3.0). Among them, 21 (25.9%) were girls and 60 boys (74.1%). Results: Patients with severe ID had a higher rate of EEG abnormalities (P=0.03) than patients without ID as well as patients with mild or moderate ID. The association remained significant after the structural MRI abnormalities were controlled (P=0.04). The severity of ID was not associated with abnormal MRI. The most frequent EEG and MRI abnormalities were active epileptic anomaly/paroxysmal abnormality and cerebral atrophy/periventricular leukomalacia, respectively. Almost a third of the EEG abnormalities were associated with temporal cortex and adjacent cortical structures. Conclusions: Consistent with previous studies, almost a fourth of the patients in this relatively large sample of patients with pervasive developmental disorders had EEG and/or MRI abnormalities. EEG results indicate that temporal cortex may play a significant role in pervasive developmental disorders.
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    Immunosuppressive Medication Adherence in Patients With Hepatocellular Cancer Who Have Undergo Liver Transplantation: A Case Control Study
    (Elsevier Science Inc, 2023) Akbulut, Sami; Tamer, Murat; Saritas, Serdar; Unal, Ozlem; Akyuz, Musap; Unsal, Selver; Kucukakcali, Zeynep
    Background. We aimed to compare the adherence to immunosuppressive medication use in patients who underwent liver transplantation (LT) due to hepatocellular carcinoma (HCC) and non-HCC reasons.Methods. The study population was determined as 242 patients with HCC and 1290 patients with non-HCC who had LT performed in our institute between March 2002 and November 2021; all these patients were contacted by phone in March 2022. The sample size was calculated using the MedCalc software program, and the number of patients required in each group was determined as 111 patients. Furthermore, we used the sample.int function, a random integer generator in the R (version 4.1.2) software program. Whereas demographic and clinical parameters were determined as independent variables, the immunosuppressive medication adherence scale (IMAS) score was determined as a dependent variable. Patients were evaluated by the IMAS. This 11-item IMAS scale evaluates the lowest compliance score as 11 and the highest as 55.Results. Out of a total number of 221 patients, 161 (72%) were men and 60 (27.1%) were women, with a median age of 58 years (IQR: 14); one patient in the non-HCC group was excluded due to lack of data. Among the HCC and non-HCC groups, significant differences were found in terms of the variables of age (P = .003), IMAS score (P < .001), sex (P = .001), working status (P = .004), chronic diseases (P = .008), tacrolimus alone (P < .001), tacrolimus plus everolimus (P < .001), and often medication changes (P < .001). A statistically significant correlation was found between the IMAS score and whether the patients had HCC (P < .001) and frequently changing immunosuppressive drugs (P = .023).Conclusion. This study showed that patients with frequent drug changes or non-HCC etiology had better adherence to immunosuppressive drug use.