Turkish Journal of Medical Sciences最新文献

{"title":"Clinical, hormonal, and treatment outcomes in 247 patients with acromegaly: a single tertiary center experience.","authors":"Ümran Gül, Bekir Uçan, Hayri Bostan, Hakan Düğer, Hayri Kertmen, Caner Ünlüer, Halil Durantaş, Oğulcan Boz, Ceren Karaçalik Ünver, Burak Menekşe, Sema Hepşen, İlknur Öztürk Ünsal, Mustafa Özbek, Erman Çakal, Muhammed Kizilgül","doi":"10.55730/1300-0144.6205","DOIUrl":"10.55730/1300-0144.6205","url":null,"abstract":"<p><strong>Background/aim: </strong>This study aimed to evaluate the demographic, clinical, and hormonal characteristics; comorbidities; surgical pathology; treatment modalities; and long-term clinical outcomes of patients diagnosed with and managed for acromegaly at our tertiary referral center over a 15-year period.</p><p><strong>Materials and methods: </strong>Between 2010 and 2024, 247 patients with acromegaly were evaluated. Diagnosis and biochemical remission were determined according to the 2024 Acromegaly Consensus Criteria.</p><p><strong>Results: </strong>The median follow-up duration was 8 years (IQR: 3-14). At the time of diagnosis, the most frequent pituitary hormone deficiency was secondary adrenal insufficiency, present in 17.8% of patients. The most common comorbidities were hypertension (HT, 42.1%) and diabetes mellitus (DM, 30.8%). At the time of diagnosis, macroadenomas were present in 153 of 193 patients (79.3%), and, according to the Knosp classification, 28.6% of tumors were grade 4. A total of 218 patients underwent surgical intervention; 86 (39.4%) achieved postoperative cure without the need for adjuvant medical therapy or radiotherapy. Postoperatively, one or more anterior pituitary hormone deficiencies were found in 34 patients (22.8%), with central hypothyroidism being the most common (52.9%). Patients who achieved biochemical remission were significantly older (p = 0.003), had a higher prevalence of HT and DM (both p < 0.05), and were more likely to exhibit positive growth hormone (GH) immunostaining (p = 0.017). In contrast, those who did not achieve remission were more likely to have higher Knosp grades (3-4) (p = 0.002).</p><p><strong>Conclusions: </strong>In this study, a favorable prognosis was associated with older age at diagnosis, lower baseline GH levels, positive GH immunostaining, smaller tumor size, and lower Knosp grade, underscoring the prognostic value of both biochemical and anatomical parameters. Further studies are warranted to refine prognostic markers and establish standardized treatment algorithms to improve long-term outcomes in acromegaly.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"718-729"},"PeriodicalIF":1.4,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A high FIB-4 score may be an early sign of severe liver involvement in patients with primary antibody deficiencies.","authors":"Hacı Uğur Muşabak, Tuba Erdoğan, Emre Özbek, Dudu Merve Durak Anşin, Zumrud Mehti","doi":"10.55730/1300-0144.6219","DOIUrl":"10.55730/1300-0144.6219","url":null,"abstract":"<p><strong>Background/aim: </strong>Liver damage is a significant complication that increases mortality and morbidity in primary immunodeficiencies (PIDs). Although biopsy is the gold standard, the fibrosis-4 (FIB-4) scoring system is a noninvasive method for diagnosing liver fibrosis. In this study, we investigated the value of the FIB-4 score as an early indicator of liver damage in patients with primary antibody deficiencies (PADs).</p><p><strong>Materials and methods: </strong>Of 52 patients, 40 had common variable immunodeficiency (CVID), 12 had immunoglobulin G subclass deficiency (IgG-SGD), and they were enrolled in the study. Patients were divided into hematology, rheumatology + dermatology, gastroenterology/hepatology, and respiratory diseases groups based on their clinical phenotypes. FIB-4 score calculation and transient elastography were used to detect liver complications.</p><p><strong>Results: </strong>FIB-4 scores were significantly higher in CVID patients than in those with SGD (p = 0.003), and were also elevated in PAD patients with hematology and gastroenterology/hepatology phenotypes compared with rheumatology + dermatology and respiratory phenotypes (p < 0.001). In the gastroenterology/hepatology group patients, FIB-4 scores showed a strong positive correlation with elastography values (<i>r</i> = 0.825, p < 0.001). FIB-4 and elastography showed moderate to good agreement (κ = 0.41-0.60) for detecting significant fibrosis, and FIB-4 was also a valuable indicator in high-risk patients (≥3.25).</p><p><strong>Conclusions: </strong>This study is the first to show that FIB-4 may serve as a practical and noninvasive indicator of liver damage in PADs.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"847-859"},"PeriodicalIF":1.4,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of Kirschner wire removal in pediatric supracondylar humerus fractures: Is early removal a safe and effective option?","authors":"Mustafa Kemal Yenidünya, Sinan Yüksel, İbrahim Faruk Adigüzel, Serhat Dinç, Önder Ersan","doi":"10.55730/1300-0144.6207","DOIUrl":"10.55730/1300-0144.6207","url":null,"abstract":"<p><strong>Background/aim: </strong>The optimal timing of Kirschner wire removal following the surgical treatment of pediatric supracondylar humerus fractures remains controversial. This study aimed to compare the clinical and radiographic outcomes of early versus late K-wire removal and to contribute to the standardization of the timing of pin removal in pediatric patients.</p><p><strong>Materials and methods: </strong>This retrospective study included 90 pediatric patients (aged 4-14 years) treated with closed reduction and percutaneous pinning for Gartland type III and IV supracondylar humerus fractures. Patients were grouped according to the timing of pin removal as early (postoperative days 21-28, n = 40) or late (after postoperative day 28, n = 50). Clinical outcomes were evaluated in the early postoperative period and at 6 months using the Mayo Elbow Score and Flynn criteria, whereas radiographic assessments at 6 months included the Baumann angle and lateral rotation percentage. Age-based subgroup analyses were performed for patients aged ≤8 years and >8 years.</p><p><strong>Results: </strong>At 6 months, the Baumann angle did not differ between groups, whereas lateral rotation percentage was significantly lower in the early removal group (p = 0.03). Overall clinical outcomes were similar between the early and late removal groups. In subgroup analyses, patients aged ≤8 years showed significantly better early postoperative Mayo Elbow Score and Flynn criteria results after early pin removal (p < 0.05), whereas no differences were observed in older patients. Clinical outcomes at 6 months were comparable across all groups.</p><p><strong>Conclusion: </strong>Early and late K-wire removal result in comparable midterm clinical and radiographic outcomes. In younger children, early pin removal after adequate stability and radiographic union have been achieved appears to be a safe and feasible option that does not compromise clinical outcomes and may reduce the need for prolonged radiographic follow-up.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"740-745"},"PeriodicalIF":1.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repurposing diclofenac for combination therapy: targeting the Warburg effect to enhance breast cancer treatment.","authors":"Gonca Tuna, Elif Ertürk, Ayşen Sağnak, Ferda Ari","doi":"10.55730/1300-0144.6373","DOIUrl":"10.55730/1300-0144.6373","url":null,"abstract":"<p><strong>Background/aim: </strong>Diclofenac (Diclo), a widely used nonsteroidal antiinflammatory drug, has emerged as a potential candidate for drug repurposing in oncology, with reported anticancer effects extending beyond cyclooxygenase (COX) inhibition, including modulation of tumor metabolism. This study investigated the antiproliferative and glycolysis-associated effects of Diclo in MCF-7 breast cancer cells, alone and in combination with docetaxel (Doc) or 5-fluorouracil (5-FU).</p><p><strong>Materials and methods: </strong>Cell viability was assessed using the sulforhodamine B (SRB) assay. To evaluate metabolic alterations, glucose uptake and lactate release were quantified following treatment. In addition, Triosephosphate Isomerase (TPI) protein levels and Lactate Dehydrogenase (LDH) activity were measured to explore potential modulation of glycolytic pathways.</p><p><strong>Results: </strong>Diclo reduced MCF-7 viability in a dose-dependent manner (IC₅₀: 78.37 μg/mL). Combining Diclo with Doc or 5-FU enhanced cytotoxicity compared with single agents. Although Diclo alone did not significantly change glucose uptake, Diclo+Doc and Diclo+5-FU significantly decreased glucose uptake, and lactate release was reduced, particularly in Diclo-containing treatments. Diclo decreased TPI levels, and Diclo-based combinations further reduced TPI. LDH activity decreased with Diclo, while certain combinations produced divergent LDH responses, suggesting treatment-dependent effects on lactate metabolism and/or cellular stress.</p><p><strong>Conclusion: </strong>Diclo potentiated the cytotoxic effects of Doc and 5-FU and was associated with reduced glycolytic readouts and decreased TPI in MCF-7 cells, supporting a potential role for Diclo as a metabolic modulator in breast cancer combination therapy.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 4","pages":"1287-1295"},"PeriodicalIF":1.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A model based on dynamic hematologic parameters to predict short term clinical events in pediatric acute lymphoblastic leukemia.","authors":"Neryal Tahta, Salih Gözmen, Sultan Okur Acar","doi":"10.55730/1300-0144.6183","DOIUrl":"10.55730/1300-0144.6183","url":null,"abstract":"<p><strong>Background/aim: </strong>Acute lymphoblastic leukemia (ALL) treatment is frequently complicated by infections, emergency visits, and therapy interruptions, yet early prediction of short-term clinical deterioration remains challenging. Traditional prognostic markers rely on static laboratory values, whereas dynamic hematologic fluctuations may provide earlier warning signals. This study presents and internally validates a clinically applicable prediction model based on dynamic hematologic parameters and clinician-documented symptoms for predicting short-term (7-day) clinical events in children with ALL.</p><p><strong>Materials and methods: </strong>Included in this retrospective study were 44 pediatric ALL patients treated with Berlin-Frankfurt-Münster-based protocols between January 2023 and June 2025. Weekly observation units were created by aggregating complete blood count values and clinician-documented symptoms. Dynamic hematologic indices included mean absolute neutrophil count (ANC), coefficient of variation (ANC-CV), and time in target range (ANC-TTR). The composite outcome was defined as any of the following occurring within 7 days: unplanned emergency visit, ≥48-h chemotherapy interruption, or infection requiring systemic antibiotics. Mixed-effects logistic regression was used to account for within-patient clustering. Model performance was assessed using discrimination, calibration, decision curve analysis, and bootstrap internal validation.</p><p><strong>Results: </strong>A total of 1136 weekly observations were analyzed. Composite clinical events occurred in 32.3% of weeks. Event weeks demonstrated lower ANC, higher ANC-CV, reduced ANC-TTR, lower hemoglobin levels, and higher symptom burden (all p <0.01). In the hematology-only model, ANC, ANC-CV, ANC-TTR, hemoglobin levels, and platelet counts were independent predictors (AUROC = 0.77). Adding the symptom score improved discrimination (AUROC = 0.83) and calibration. Decision curve analysis demonstrated greater net clinical benefit for the combined model across threshold probabilities of 10-40%.</p><p><strong>Conclusion: </strong>Dynamic hematologic trajectories and clinician-documented symptoms enable accurate early prediction of short-term clinical events in pediatric ALL. This low-cost, accessible prediction model may support individualized risk stratification and proactive supportive care.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"489-496"},"PeriodicalIF":1.4,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of injectable and conventional pulmonary valve replacement in severe pulmonary regurgitation.","authors":"Sercan Tak, Murat Koç, Ali Kutsal, Vehbi Doğan","doi":"10.55730/1300-0144.6211","DOIUrl":"10.55730/1300-0144.6211","url":null,"abstract":"<p><strong>Background/aim: </strong>Pulmonary regurgitation following tetralogy of Fallot repair is a common long-term complication requiring pulmonary valve replacement. Injectable bioprosthetic valves offer a less invasive alternative to conventional surgical replacement, but comparative data in pediatric populations remain limited. This study aimed to evaluate short-term and long-term clinical outcomes of injectable pulmonary valve replacement and conventional pulmonary valve replacement in pediatric patients with severe pulmonary regurgitation following tetralogy of Fallot repair.</p><p><strong>Materials and methods: </strong>This retrospective study included 22 pediatric patients who underwent pulmonary valve replacement. Patients were divided into injectable (n = 9) and conventional (n = 13) groups based on anatomical criteria. Primary outcomes included early postoperative parameters and long-term valve function. The mean follow-up duration was 10.5 ± 2.5 years.</p><p><strong>Results: </strong>Favorable early outcomes were noted in the injectable pulmonary valve replacement cohort, including shorter intensive care unit stay (16.8 ± 6.2 vs. 37.0 ± 23.4 h, p = 0.021), reduced mechanical ventilation duration (5.2 ± 3.9 vs. 15.4 ± 11.4 h, p = 0.019), decreased chest tube drainage (206.7 ± 108.2 vs. 513.1 ± 274.1 mL, p = 0.005), and shorter hospital stay (5.4 ± 2.4 vs. 8.4 ± 3.1 days, p = 0.026). Long-term outcomes indicated similar valve function and right ventricular remodeling in the two groups, with excellent freedom from reintervention (100%) during follow-up.</p><p><strong>Conclusion: </strong>Injectable pulmonary valve replacement appears to be a safe alternative, offering favorable early outcomes and long-term valve performance comparable to conventional methods. However, clinical experience and precise patient selection remain critical for achieving optimal results.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"778-786"},"PeriodicalIF":1.4,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary DKK3 as a predictor of CKD stages in reflux nephropathy in children.","authors":"Ayşe Seda Pinarbaşi, Neslihan Günay, İnayet Güntürk, Didem Barlak Keti, Sibel Yel, Sekure Rabia Ulueren, Cevat Yazici, Hakan M Poyrazoğlu, İsmail Dursun","doi":"10.55730/1300-0144.6215","DOIUrl":"10.55730/1300-0144.6215","url":null,"abstract":"<p><strong>Background/aim: </strong>Reflux nephropathy is an important cause of chronic kidney disease (CKD) in children. The search for new biomarkers continues, as early intervention is important to slow the progression of CKD. Urinary Dickkopf-3 (uDKK3), a potential marker of tubulointerstitial fibrosis, has been studied in adults but not extensively in children with CKD. This study was conducted to determine the role of uDKK3 levels in predicting the CKD stage in children with reflux nephropathy.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 113 children with CKD stages 1-4 with reflux nephropathy and 28 healthy controls. uDKK3 concentrations were measured using enzyme-linked immunosorbent assay. The association between uDKK3, the estimated glomerular filtration rate (eGFR), and albuminuria was investigated. Receiver operating characteristic (ROC) curves were used to assess diagnostic performance.</p><p><strong>Results: </strong>uDKK3 levels were significantly higher in CKD stages 3 and 4 compared to stages 1 and 2 and the control group. A strong negative correlation was observed between uDKK3 and the eGFR, while a positive correlation was noted with albuminuria. ROC analysis revealed an area under the curve (AUC) of 0.77 for the uDKK3 to urinary Cr (uCr) ratio (uDKK3/uCr), with a sensitivity of 71.1% and a specificity of 71.4% at a cutoff value of 1675.48 pg/mg.</p><p><strong>Conclusion: </strong>The correlation between the uDKK3/uCr and CKD severity suggests that uDKK3 may serve as a potential noninvasive biomarker for assessing disease severity. However, its utility for identifying early-stage CKD could not be clearly demonstrated in this cohort. uDKK3 appears to be particularly associated with advanced CKD stages, and further large-scale prospective studies are needed to clarify its clinical applicability and prognostic value in pediatric CKD.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"808-816"},"PeriodicalIF":1.4,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations in gut microbiota composition in adult patients with familial Mediterranean fever: a pilot case-control study.","authors":"Nazife Şule Yaşar Bilge, Vicente Perez Brocal, Timuçin Kaşifoğlu, Uğur Bilge, Nilgün Kaşifoğlu, Andres Moya, Ener Çağrı Dinleyici","doi":"10.55730/1300-0144.6214","DOIUrl":"10.55730/1300-0144.6214","url":null,"abstract":"<p><strong>Background/aim: </strong>Although familial Mediterranean fever (FMF) is a monogenic disease, recent evidence suggests that the gut microbiota may play a role in its pathogenesis or phenotypic expression. We conducted a pilot exploratory study to evaluate the intestinal microbiota composition in patients with FMF and compare it to that of healthy controls.</p><p><strong>Materials and methods: </strong>In this prospective cohort study, 10 adult patients with FMF receiving colchicine and 10 age- and sex-matched healthy controls were enrolled. Fecal samples were collected and stored at -80 °C until DNA extraction. The V3-V4 region of the 16S rRNA gene was amplified and sequencing was performed.</p><p><strong>Results: </strong>Alpha and beta diversity metrics were largely similar between FMF patients and the control group, except for the Chao 1 index, which was significantly reduced in the FMF group (p < 0.05), indicating lower species richness. Taxonomic analysis revealed differences in gut microbiota composition, notably an increased abundance of <i>Eggerthella</i> at the genus level. At the species level, <i>Eggerthella sinensis</i> and <i>Eggerthella lenta</i> were more prevalent in FMF patients.</p><p><strong>Conclusion: </strong>Our findings reveal distinct gut microbiota alterations in FMF patients, characterized by reduced microbial richness and particularly enrichment of <i>Eggerthella</i>, including <i>E. lenta</i>. These findings suggest a possible association between gut microbiota alterations and FMF. The small sample size of this study is a limitation, but further longitudinal studies with treatment-naïve patients, alongside functional analyses of microbial metabolites, are warranted to elucidate causal relationships and inform microbiome-based diagnostic or therapeutic strategies in FMF.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"801-807"},"PeriodicalIF":1.4,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of CALR-mutated essential thrombocythemia as a distinct disease entity compared with JAK2 V617F-mutated and triple-negative patients.","authors":"Gökhan Sami Aydin, Elif Aksoy, İpek Yönal Hindilerden, Aynur Dağlar Aday, Emine Gültürk, Meliha Nalçaci, Fehmi Hindilerden","doi":"10.55730/1300-0144.6184","DOIUrl":"10.55730/1300-0144.6184","url":null,"abstract":"<p><strong>Background/aim: </strong>Calreticulin (CALR) mutations in essential thrombocythemia (ET) are associated with younger age, higher platelet counts, and lower thrombosis rates. The present study analyzes the demographic, laboratory, and clinical features of the CALR mutation and its prognostic impact.</p><p><strong>Materials and methods: </strong>The clinical impact of CALR mutations was assessed in 391 ET patients.</p><p><strong>Results: </strong>CALR-mutation patients were more commonly male than JAK2 V617F-positive and triple-negative patients. Age at diagnosis was similar across all groups, although patients with type 2 CALR mutations were younger than those with nontype 1/nontype 2 mutations. Compared with JAK2 V617F-positive patients, CALR-mutation patients had lower leukocyte counts (9.6 × 10⁹/L vs. 10.9 × 10⁹/L), lower hemoglobin (Hb) and hematocrit (Hct) levels, higher platelet counts (1078.5 × 10⁹/L vs. 858.1 × 10⁹/L), and lower total thrombosis rates (20.8% vs. 37.8%), while the CALR-mutated and triple-negative patients had lower venous thrombosis rates than in the JAK2 V617F-positive patients. The arterial thrombosis rate before and at the time of diagnosis was lower in the CALR-mutation patients than in the JAK2 V617F-positive patients, and the total venous thrombosis rate in patients aged <60 years at the time of diagnosis was lower in the CALR-mutation and triple-negative patients than in the JAK2 V617F-positive patients. Multivariable analysis revealed cardiovascular (CV) risk to be the only independent predictor of total thrombosis. Female gender, absence of CV risk, and platelet count ≥1000 × 10⁹/L were associated with a lower incidence of arterial thrombosis. Age <60 years was associated with lower risks of arterial and venous thrombosis. Overall, thrombosis-free, and leukemia-free survival were similar across all groups, while myelofibrosis-free survival was longer in the type 2 CALR-mutation group.</p><p><strong>Conclusion: </strong>The CALR mutation was lower among females, and was associated with lower leukocyte counts, and Hb and Hct levels, and with higher platelet counts. In multivariable analysis, the apparent protective association of CALR with thrombosis was not independent.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"497-508"},"PeriodicalIF":1.4,"publicationDate":"2026-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HLA allele and haplotype diversity in Central Anatolia: a comparative analysis of donors and transplant candidates across six HLA loci (HLA-A, HLA-B, HLA-C, HLA-DRB1, HLA-DQB1, and HLA-DPB1).","authors":"Emel Yantir, Eren Gündüz","doi":"10.55730/1300-0144.6216","DOIUrl":"10.55730/1300-0144.6216","url":null,"abstract":"<p><strong>Background/aim: </strong>Human leukocyte antigen (HLA) polymorphisms play a central role in immune recognition, disease susceptibility, and transplant success. The distribution of HLA alleles and haplotypes varies among ethnic and geographic populations. Despite several regional studies conducted in Türkiye, large-scale and comprehensive investigations comparing HLA profiles between healthy individuals and transplant candidates remain limited. The aim of this study was to compare the distribution of HLA profiles among donors, hematopoietic stem cell transplantation (HSCT) candidates, and solid organ transplant candidates.</p><p><strong>Materials and methods: </strong>A total of 8472 individuals were included in the study, comprising 6422 donors and 2050 transplant candidates. HLA genotyping was performed using polymerase chain reaction with sequence-specific primers and polymerase chain reaction with sequence-specific oligonucleotide probes. Allele, genotype, and haplotype frequencies were calculated using the PyPop (version 1.2.0) and GENE[RATE] software tools.</p><p><strong>Results: </strong>The most frequent alleles at the HLA-A, HLA-B, HLA-C, HLA-DRB1, HLA-DQB1, and HLA-DPB1 loci were similar across all groups, with A*02, B*35, C*07, DRB1*11, DQB1*03, and DPB1*04 observed as the predominant alleles. Several alleles were significantly overrepresented in solid organ transplant candidates compared with donors, including A*31, A*33, B*15, B*42, B*51, B*54, DRB1*04, and DRB1*12, whereas DRB1*11 was significantly underrepresented (p < 0.05). A*23 was also observed at a significantly higher frequency in kidney transplant candidates. No significant allele differences were observed between HSCT candidates and donors. Haplotype analysis revealed that the most prevalent six-locus haplotype (A:B:C:DRB1:DQB1:DPB1) was 02~35~04~11~03~04 in donors, whereas 24~35~04~11~03~04 was observed in HSCT candidates and 24~35~04~04~03~04 in solid organ transplant candidates.</p><p><strong>Conclusion: </strong>To our knowledge, this study represents the largest and most comprehensive analysis of HLA distribution in Türkiye to date and the first to report six-locus HLA haplotypes, including the HLA-DPB1 locus, in transplant candidates. The results indicate that solid organ transplant candidates exhibit significant differences in HLA allele and haplotype frequencies compared with healthy donors. These findings underscore the importance of region-specific HLA data in optimizing donor selection and potentially improving transplant outcomes.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 3","pages":"817-827"},"PeriodicalIF":1.4,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}