Balkan Medical Journal最新文献

{"title":"Cannabinoids: Medicine or Poison.","authors":"Yasemin Karal","doi":"10.4274/balkanmedj.galenos.2025.2025.290925","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025.290925","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Diagnostic Accuracy in Bethesda III Thyroid Nodules: The Predictive Value of Serum IL-17A and Calprotectin.","authors":"Muzaffer Serdar Deniz, Fatih Karataş, Öykü Uludağ","doi":"10.4274/balkanmedj.galenos.2025.2025-7-125","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025-7-125","url":null,"abstract":"<p><strong>Background: </strong>Thyroid nodules are common in clinical practice, with malignancy detected in about 5% of cases. Current risk-stratification approaches, which rely on sonographic features and cytopathological assessment, have notable limitations, especially for indeterminate nodules categorized as Bethesda III.</p><p><strong>Aims: </strong>To address these diagnostic challenges, this study evaluated the utility of preoperative serum interleukin (IL)-17A and calprotectin levels as potential biomarkers for distinguishing malignant from benign Bethesda III thyroid nodules.</p><p><strong>Study design: </strong>This single-center prospective methodological study.</p><p><strong>Methods: </strong>In this prospective study, 76 patients with Bethesda III nodules scheduled for thyroidectomy were enrolled. Based on histopathological findings, nodules were classified as benign (n = 41) or malignant (n = 35). Comprehensive patient information was collected, including demographics, medical history, and detailed clinical parameters related to nodule characteristics and laboratory results. Circulating biomarkers measured included thyroid-stimulating hormone, free T3, free T4, thyroglobulin (TG), anti-TG, anti-thyroid peroxidase, calcitonin, IL-17A, and calprotectin.</p><p><strong>Results: </strong>Patients with malignant nodules (n = 35) exhibited significantly higher preoperative IL-17A and calprotectin levels compared with those with benign nodules (n = 41) (<i>p</i> < 0.001 and <i>p</i> = 0.038, respectively). receiver operating characteristic analysis demonstrated promising diagnostic performance for IL-17A [area under the curve (AUC) = 0.733] and calprotectin (AUC = 0.639).</p><p><strong>Conclusion: </strong>IL-17A and calprotectin emerge as promising biomarkers for refining Bethesda III nodule stratification. Incorporating these inflammatory markers into existing diagnostic protocols may substantially reduce unnecessary surgical interventions, thereby alleviating patient anxiety, surgical risks, and healthcare costs.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive Symptoms and Risk of Hearing Loss Among Adults Aged 55 Years and Older: A Population-Based Study.","authors":"Erjie Xie, Yuedi Tang","doi":"10.4274/balkanmedj.galenos.2025.2025-6-78","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025-6-78","url":null,"abstract":"<p><strong>Background: </strong>Depression and hearing loss (HL) commonly occur in the aging population and may arise from shared mechanisms.</p><p><strong>Aims: </strong>To investigate the observational associations between depression and HL.</p><p><strong>Study design: </strong>Observational study.</p><p><strong>Methods: </strong>Adults aged ≥ 55 years from three nationally representative study cohorts were included: the National Health and Nutrition Examination Survey, the Health and Retirement Study, and the English Longitudinal Study of Ageing. Multiple linear regression was applied to examine the association between depressive severity and audiometric thresholds. Cox regression models were applied to evaluate the associations between depressive symptoms and HL.</p><p><strong>Results: </strong>Cross-sectional analyses revealed that depression was significantly associated with higher pure-tone average thresholds. In pooled longitudinal analyses of 6,956 participants, individuals with baseline depression exhibited a higher incidence of HL when compared to their non-depressed counterparts. Longitudinal trajectory analyses identified three significant patterns: increasing [hazard ratio: (HR) 1.48, 95% confidance interval (CI) 1.09-2.21] and fluctuating (HR 1.25, 95% CI 1.12-1.39) depressive symptom trajectories as independent predictors of HL, whereas decreasing trajectories indicated no significant association.</p><p><strong>Conclusion: </strong>Depression and specific longitudinal trajectories are associated with elevated risk of HL. To further understand this association, integrated care models that synergistically address depression and HL in older adults are warranted.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secukinumab-Induced Interstitial Pneumonia in a Patient with Psoriasis.","authors":"Siqi Li, Ru Dai, Qunye Xu","doi":"10.4274/balkanmedj.galenos.2025.2025-8-43","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025-8-43","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fat Mass and Obesity-Associated Protein-Mediated Adipogenic Differentiation of Bone Marrow Mesenchymal Stem Cells Promotes Chemotherapy Resistance in Acute Myeloid Leukemia.","authors":"Pan Zhipeng, Kang Lixia, Chen Ling","doi":"10.4274/balkanmedj.galenos.2025.2025-7-150","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025-7-150","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy resistance and relapse in acute myeloid leukemia (AML) are associated with poor prognosis. Bone marrow mesenchymal stem cells (MSCs) show enhanced adipogenic differentiation in AML, which may contribute to chemoresistance; however, the underlying mechanisms remain incompletely understood.</p><p><strong>Aims: </strong>To investigate how adipogenic differentiation of MSCs from chemotherapy-resistant AML patients (CR-AML-MSCs) promotes chemoresistance, focusing on the roles of the fat mass and obesity-associated protein (FTO) and the mTORC1 pathway.</p><p><strong>Study design: </strong>Experimental study.</p><p><strong>Methods: </strong>This study compared bone marrow MSCs from chemotherapy-sensitive (CS) and CR AML patients. Adipogenic differentiation was assessed using Oil Red O staining. RNA sequencing, qPCR, and western blotting were employed to analyze expression of FTO, Raptor, and PPARγ. Global m⁶A levels were measured, and co-culture models with AML cell lines (U937, HL-60, THP-1) were established to evaluate chemoresistance. Gain- and loss-of-function experiments for FTO were performed using lentiviral overexpression and shRNA knockdown. mTORC1 pathway involvement was tested using rapamycin. Statistical analyses included t-tests and ANOVA, with significance set at (<i>p</i> < 0.05). MSCs from chemotherapy-sensitive and resistant AML patients were compared. Adipogenic differentiation was induced and assessed by Oil Red O staining. RNA sequencing, qPCR, and western blotting were used to analyze the expression of FTO, Raptor, and PPARγ. Global m⁶A levels were measured, and co-culture models with AML cell lines (U937, HL-60, THP-1) were established to evaluate chemoresistance. Gain- and loss-of-function experiments for FTO were performed.</p><p><strong>Results: </strong>CR-AML-MSCs exhibited significantly enhanced adipogenic differentiation (<i>p</i> < 0.01) and elevated PPARγ expression. Co-culture with adipocyte-differentiated CR-AML-MSCs markedly increased resistance to daunorubicin and cytarabine in AML cells (<i>p</i> < 0.01). RNA-Seq analysis revealed enrichment of the mTORC1 signaling pathway and upregulation of raptor. Inhibition of mTORC1 with rapamycin suppressed adipogenic differentiation. Total m⁶A levels were reduced in CR-AML-MSCs, whereas FTO expression was increased. Overexpression of FTO further promoted adipogenesis, upregulated raptor and PPARγ, and enhanced chemoresistance, whereas FTO knockdown attenuated these effects.</p><p><strong>Conclusion: </strong>FTO enhances adipogenic differentiation of CR-AML-MSCs through m⁶A demethylation of raptor, leading to mTORC1 pathway activation and subsequent chemoresistance. These findings reveal a novel mechanism underlying AML chemoresistance and suggest potential therapeutic targets.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factor XI/XIa Inhibitors: Promising Agents for the Secondary Prevention of Ischemic Stroke.","authors":"Murat Mert Atmaca","doi":"10.4274/balkanmedj.galenos.2025.2025.160925","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025.160925","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystic Bronchiectasis due to AIDS: Case, and References.","authors":"Songyang Pan, Miao Chen, Tianyang Dai","doi":"10.4274/balkanmedj.galenos.2025.2025-8-80","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025-8-80","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Important Feature of Gastric Adenocarcinoma: Heterogeneous Microsatellite Status.","authors":"Mirac Ajredini, Arda Ulaş Mutlu, Sibel Erdamar Çetin, Rümeysa Atabey, Erman Aytaç, Leyla Özer","doi":"10.4274/balkanmedj.galenos.2025.2025-7-281","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025-7-281","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uric Acid-Lowering Therapy with Febuxostat in Patients with Chronic Heart Failure and Hyperuricemia: A Prospective and Observational Cohort Study.","authors":"Jiahan Ke, Xiaohan Qiu, Min Wang, Huasu Zeng, Changqian Wang, Junfeng Zhang, Huafang Zhu, Jun Gu","doi":"10.4274/balkanmedj.galenos.2025.2025-6-168","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025-6-168","url":null,"abstract":"<p><strong>Background: </strong>Hyperuricemia is associated with poor clinical outcomes in several cardiovascular diseases, including heart failure (HF). However, whether lowering serum uric acid (SUA) levels improves the prognosis of HF remains insufficiently studied.</p><p><strong>Aims: </strong>To evaluate whether urate-lowering therapy (ULT) with febuxostat confers clinical benefits in patients with HF and concomitant hyperuricemia.</p><p><strong>Study design: </strong>Prospective, observational cohort study.</p><p><strong>Methods: </strong>Patients with chronic HF and hyperuricemia were enrolled and assigned either to a febuxostat group or to a non-ULT group and were followed prospectively for 5 years. The primary endpoint was all-cause mortality or rehospitalization for HF.</p><p><strong>Results: </strong>Among 2005 patients, those with higher SUA levels experienced more endpoint events. After propensity score matching, we found that febuxostat therapy significantly reduced the incidence of primary endpoints in patients with HFwith preserved ejection fraction (HFpEF) [<i>p</i> = 0.012; hazard ratios (HR), 0.744; 95% confidence intervals (CI), 0.589-0.939], but not in those with HF with reduced ejection fraction (HFrEF) or mildly reduced ejection fraction (HFmrEF) (<i>p</i> = 0.234; HR, 0.894; 95% CI, 0.742-1.077). The benefits of febuxostat in HFpEF were most evident in patients within the highest tertiles of B-type natriuretic peptide (BNP) (<i>p</i> = 0.021; HR, 0.647; 95% CI, 0.436-0.960) and SUA (<i>p</i> = 0.025; HR, 0.651; 95% CI, 0.441-0.963).</p><p><strong>Conclusion: </strong>High SUA levels are associated with increased all-cause mortality and rehospitalization for HF. Febuxostat-mediated SUA reduction significantly improved clinical outcomes in patients with HFpEF, particularly those with elevated SUA and BNP levels.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Metastatic Ameloblastoma: A Hidden Cause of Pulmonary Nodules.","authors":"İrem Karaman, Barış Hekimoğlu, Mürüvvet Akçay Çelik, Dilek Erdem, Şevket Özkaya","doi":"10.4274/balkanmedj.galenos.2025.2025-8-6","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025-8-6","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}