Turkiye Klinikleri Journal of Pediatrics

.: REVIEW
Otizm Spektrum Bozukluğunda D Vitamini
Vitamin D in Autism Spectrum Disorder
Tuğçe ÖZLÜa, Ezgi ARSLANa, Emre Batuhan KENGERa, Can ERGÜNa
aBahçeşehir Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, İstanbul, TÜRKİYE
Turkiye Klinikleri J Pediatr. 2020;29(2):107-14
doi: 10.5336/pediatr.2020-74191
Article Language: TR
Full Text
ÖZET
 Otizm spektrum bozukluğu (OSB); sosyo-iletişimsel işlevsellikteki bozulma, sınırlı ilgi alanları, tekrarlayan veya kalıplaşmış davranışlar ile karakterize olarak görülen bir nörogelişimsel bozukluktur. Epidemiyolojik çalışmalar, OSB farkındalığının artması ve tanı kriterleri ve teşhis yöntemlerinin genişletilmesiyle birlikte OSB prevalansının son 50 yılda arttığını göstermiştir. Yapılan çalışmalar, OSB görülme riski ile D vitamini yetersizliği arasında ilişki olduğunu göstermektedir. Bu derlemede D vitamini ve OSB arasındaki ilişkiyi inceleyen çalışmalar ele alınmıştır. İncelenen sekiz kesitsel çalışmanın tümünde OSB'li çocuklarda serum D vitamini düzeyinin düşük olduğu saptanmıştır. D vitamininin OSB'li çocuklarda tedavi amaçlı kullanımına yönelik incelenen beş çalışmanın dördünde olumlu etkileri olduğu belirlenmiştir. Ayrıca değerlendirilen çalışmalar, gebelik sırasında maternal D vitamini seviyelerinin düşmesinin ve güneş ışığına olan maruziyetin azalmasının OSB riskini arttırabileceğini göstermiştir. D vitamini eksikliğinin, mutasyona uğramış genlerin onarılmaması ile birçok de novo gen mutasyonu oluşumu sonucu OSB patogenezine etki ettiği düşünülmektedir. Başka bir görüşe göre, D vitamini yetersizliği sonucu azalan antioksidan savunmanın OSB olan bireylerin beyninde gerçekleşen nöroglial aktivasyon ve nöroinflamasyon sürecine etki ettiği düşünülmektedir. D vitaminin OSB ile ilişkisi göz önüne alındığında, yetersizlik riski olan gebelerin ve OSB'li çocukların D vitamini eksikliği yönünden taranması ve gerekli durumlarda uygun tedavinin planlanması önem arz etmektedir. OSB'nin önlenmesi ve/veya tedavisinde yapılacak olan randomize kontrollü çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler: Otizm spektrum bozukluğu; D vitamini; tedavi; maternal
ABSTRACT
 Autism spectrum disorder (ASD) is a neurodevelopmental disorder which is characterized by impaired socio-communicative functionality, limited interests, recurrent or stereotyped behaviors. Epidemiological studies have shown that the prevalence of ASD has increased in the last 50 years even if the increase of awareness of ASD and the expansion of diagnostic criteria and diagnostic methods of ASD. Many studies demonstrated that there is an association between the risk of ASD and vitamin D deficiency. In this, review, studies examined the relationship between vitamin D and ASD were considered. All of the examined cross-sectional studies showed that the serum vitamin D level was low among children with ASD. In addition, it was determined that as a therapeutic purpose, vitamin D had positive impacts on children with ASD. On the other hand, investigated studies demonstrated that reduced maternal vitamin D levels during pregnancy and exposure to sunlight may increase the risk of ASD. It has been believed that vitamin D deficiency affects ASD pathogenesis due to the formation of many de novo gene mutations by not repairing the mutated genes. According to another opinion, it has been suggested that the decreased antioxidant defenses as a result of vitamin D deficiency affect the neuroglial activation and neuroinflammation process in the brain of individuals with ASD. As the relationship of vitamin D with ASD, it is crucial to screen pregnant women who are at risk of deficiency and children with ASD in terms of vitamin D deficiency and to plan appropriate treatment if necessary. Randomized controlled trials are required to be carried out in the prevention and/or treatment of ASD.

Keywords: Autism spectrum disorders; vitamin D; treatment; maternal
REFERENCES:
  1. Cautionary Statement for Forensic Use of DSM-5. In: Diagnostic and Statistical Manual of Mental Disorders (Internet). American Psychiatric Association; 2013. (cited 2020 Feb 4). (DSM Library). Available from: https://dsm.psychiatryonline.org/doi/10.1176/appi.books.9780890425596.CautionaryStatement.
  2. Ozbaran B. [Do environmental factors have influence on autism spectrum disorder?]. The Journal of Pediatric Research. 2014;1(4):170-3. [Crossref] 
  3. Ranjan S, Nasser JA. Nutritional status of individuals with autism spectrum disorders: do we know enough? Adv Nutr. 2015;6(4):397-407. [Crossref]  [PubMed]  [PMC] 
  4. Fujiwara T, Morisaki N, Honda Y, Sampei M, Tani Y. Chemicals, nutrition, and autism spectrum disorder: a mini-review. Front Neurosci. 2016;10:174. [Crossref] 
  5. Neggers YH. Increasing prevalence, changes in diagnostic criteria, and nutritional risk factors for autism spectrum disorders. ISRN Nutr. 2014;2014:514026. [Crossref]  [PubMed]  [PMC] 
  6. Jia F, Wang B, Shan L, Xu Z, Staal WG, Du L. Core symptoms of autism improved after vitamin D supplementation. Pediatrics. 2015;135(1):e196-8. [Crossref]  [PubMed] 
  7. Wang T, Shan L, Du L, Feng J, Xu Z, Staal WG, et al. Serum concentration of 25-hydroxyvitamin D in autism spectrum disorder: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry. 2016;25(4):341-50. [Crossref]  [PubMed] 
  8. Mazahery H, Camargo CA, Conlon C, Beck KL, Kruger MC, von Hurst PR. Vitamin D and autism spectrum disorder: a literature review. Nutrients. 2016;8(4):236. [Crossref]  [PubMed]  [PMC] 
  9. Sotodehasl N, Tamadon MR, Malek F. Vitamin D deficiency and autism; a review on recent findings. J Parathyr Dis. 2017;6(1):7-12. [Crossref] 
  10. Lee BK, Eyles DW, Magnusson C, Newschaffer CJ, McGrath JJ, Kvaskoff D, et al. Developmental vitamin D and autism spectrum disorders: findings from the Stockholm Youth Cohort. Mol Psychiatry. 2019;1-11. [Crossref] 
  11. Kočovská E, Fernell E, Billstedt E, Minnis H, Gillberg C. Vitamin D and autism: clinical review. Res Dev Disabil. 2012;33(5):1541-50. [Crossref]  [PubMed] 
  12. Mostafa GA, Al-Ayadhi LY. Reduced serum concentrations of 25-hydroxy vitamin D in children with autism: relation to autoimmunity. J Neuroinflammation. 2012;9:201. [Crossref]  [PubMed]  [PMC] 
  13. Arastoo AA, Khojastehkia H, Rahimi Z, Khafaie MA, Hosseini SA, Mansouri MT, et al. Evaluation of serum 25-hydroxy vitamin D levels in children with autism Spectrum disorder. Ital J Pediatr. 2018;44(1):150. [Crossref]  [PubMed]  [PMC] 
  14. Meguid NA, Hashish AF, Anwar M, Sidhom G. Reduced serum levels of 25-hydroxy and 1,25-dihydroxy vitamin D in Egyptian children with autism. J Altern Complement Med. 2010;16(6):641-5. [Crossref]  [PubMed] 
  15. Saad K, Abdel-Rahman AA, Elserogy YM, Al-Atram AA, Cannell JJ, Bjørklund G, et al. Vitamin D status in autism spectrum disorders and the efficacy of vitamin D supplementation in autistic children]. Nutr Neurosci. 2016;19(8):346-51. [Crossref]  [PubMed] 
  16. Feng J, Shan L, Du L, Wang B, Li H, Wang W, et al. Clinical improvement following vitamin D3 supplementation in Autism Spectrum Disorder. Nutr Neurosci. 2017;20(5):284-90. [Crossref]  [PubMed] 
  17. Guo M, Zhu J, Yang T, Lai X, Lei Y, Chen J, et al. Vitamin A and vitamin D deficiencies exacerbate symptoms in children with autism spectrum disorders. Nutr Neurosci. 2019;22(9):637-47. [Crossref]  [PubMed] 
  18. Altun H, Kurutaş EB, Şahin N, Güngör O, Fındıklı E. The levels of vitamin D, vitamin D receptor, homocysteine and complex B vitamin in children with autism spectrum disorders. Clin Psychopharmacol Neurosci. 2018;16(4):383-90. [Crossref]  [PubMed]  [PMC] 
  19. Garipardic M, Doğan M, Bala KA, Mutluer T, Kaba S, Aslan O, et al. Association of attention deficit hyperactivity disorder and autism spectrum disorders with mean platelet volume and vitamin D. Med Sci Monit. 2017;23:1378-84. [Crossref]  [PubMed]  [PMC] 
  20. Bener A, Khattab AO, Bhugra D, Hoffmann GF. Iron and vitamin D levels among autism spectrum disorders children. Ann Afr Med. 2017;16(4):186-91. [Crossref]  [PubMed]  [PMC] 
  21. Cannell JJ, Grant WB. What is the role of vitamin D in autism? Dermatoendocrinol. 2013;5(1):199-204. [Crossref]  [PubMed]  [PMC] 
  22. Patrick RP, Ames BN. Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism. FASEB J. 2014;28(6):2398-413. [Crossref]  [PubMed] 
  23. Kerley CP, Power C, Gallagher L, Coghlan D. Lack of effect of vitamin D3 supplementation in autism: a 20-week, placebo-controlled RCT. Arch Dis Child. 2017;102(11):1030-6. [Crossref]  [PubMed] 
  24. Azzam HME, Sayyah H, Youssef S, Lotfy H, Abdelhamid IA, Abd Elhamed HA, et al. Autism and vitamin D: an intervention study. Middle East Current Psychiatry. 2015;22(1):9. [Crossref] 
  25. Preti A, Melis M, Siddi S, Vellante M, Doneddu G, Fadda R. Oxytocin and autism: a systematic review of randomized controlled trials. J Child Adolesc Psychopharmacol. 2014;24(2):54-68. [Crossref]  [PubMed] 
  26. Holló A, Clemens Z, Kamondi A, Lakatos P, Szűcs A. Correction of vitamin D deficiency improves seizure control in epilepsy: a pilot study. Epilepsy Behav. 2012;24(1):131-3. [Crossref]  [PubMed] 
  27. Ginde AA, Sullivan AF, Mansbach JM, Camargo CA Jr. Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States. Am J Obstet Gynecol. 2010;202(5):436.e1-8. [Crossref]  [PubMed]  [PMC] 
  28. Vinkhuyzen AA, Eyles DW, Burne TH, Blanken LM, Kruithof CJ, Verhulst F, et al. Gestational vitamin D deficiency and autism spectrum disorder. BJPsych Open. 2017;3(2):85-90. [Crossref]  [PubMed]  [PMC] 
  29. Vinkhuyzen AA, Eyles DW, Burne TH, Blanken LM, Kruithof CJ, Verhulst F, et al. Gestational vitamin D deficiency and autism-related traits: the Generation R Study. Mol Psychiatry. 2018;23(2):240-6. [Crossref]  [PubMed]  [PMC] 
  30. Stubbs G, Henley K, Green J. Autism: will vitamin D supplementation during pregnancy and early childhood reduce the recurrence rate of autism in newborn siblings? Med Hypotheses. 2016;88:74-8. [Crossref]  [PubMed] 
  31. Ko P, Burkert R, McGrath J, Eyles D. Maternal vitamin D3 deprivation and the regulation of apoptosis and cell cycle during rat brain development. Brain Res Dev Brain Res. 2004;153(1):61-8. [Crossref]  [PubMed] 
  32. Féron F, Burne THJ, Brown J, Smith E, McGrath JJ, Mackay-Sim A, et al. Developmental Vitamin D3 deficiency alters the adult rat brain. Brain Res Bull. 2005;65(2):141-8. [Crossref]  [PubMed] 
  33. Becker A, Eyles DW, McGrath JJ, Grecksch G. Transient prenatal vitamin D deficiency is associated with subtle alterations in learning and memory functions in adult rats. Behav Brain Res. 2005;161(2):306-12. [Crossref]  [PubMed] 
  34. Eyles DW, Burne THJ, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013;34(1):47-64. [Crossref]  [PubMed] 
  35. Karras SN, Wagner CL, Castracane VD. Understanding vitamin D metabolism in pregnancy: from physiology to pathophysiology and clinical outcomes. Metabolism. 2018;86:112-23. [Crossref]  [PubMed] 
  36. Adams JS, Hewison M. Unexpected actions of vitamin D: new perspectives on the regulation of innate and adaptive immunity. Nat Clin Pract Endocrinol Metab. 2008;4(2):80-90. [Crossref] 
  37. Lee BK, Magnusson C, Gardner RM, Blomström Å, Newschaffer CJ, Burstyn I, et al. Maternal hospitalization with infection during pregnancy and risk of autism spectrum disorders. Brain Behav Immun. 2015;44:100-5. [Crossref]  [PubMed]  [PMC] 
  38. Vuillermot S, Luan W, Meyer U, Eyles D. Vitamin D treatment during pregnancy prevents autism-related phenotypes in a mouse model of maternal immune activation. Mol Autism. 2017;8:9. [Crossref]  [PubMed]  [PMC] 
  39. Ali A, Cui X, Alexander S, Eyles D. The placental immune response is dysregulated developmentally vitamin D deficient rats: relevance to autism. J Steroid Biochem Mol Biol. 2018;180:73-80. [Crossref]  [PubMed] 
  40. Jones KL, Croen LA, Yoshida CK, Heuer L, Hansen R, Zerbo O, et al. Autism with intellectual disability is associated with increased levels of maternal cytokines and chemokines during gestation. Mol Psychiatry. 2017;22(2):273-9. [Crossref]  [PubMed]  [PMC] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com