Balkan Medical Journal最新文献

{"title":"A Deep Learning-Based Automatic Recognition Model for Polycystic Ovary Ultrasound Images","authors":"Baihua Zhao, Lieming Wen, Yunxia Huang, Yaqian Fu, Shan Zhou, Jieyu Liu, Minghui Liu, Yingjia Li","doi":"10.4274/balkanmedj.galenos.2025.2025-5-114","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-5-114","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) has a significant impact on endocrine metabolism, reproductive function, and mental health in women of reproductive age. The accuracy of ultrasound in identifying polycystic ovarian morphology remains variable.</p><p><strong>Aims: </strong>To develop a deep learning model capable of rapidly and accurately identifying PCOS using ovarian ultrasound images.</p><p><strong>Study design: </strong>Prospective diagnostic accuracy study.</p><p><strong>Methods: </strong>This prospective study included data from 1,751 women with suspected PCOS with clinical and ultrasound information collected and archived. Patients from center 1 were randomly divided into a training set and an internal validation set in a 7:3 ratio, while patients from center 2 served as the external validation set. Using the YOLOv11 deep learning framework, an automated recognition model for ovarian ultrasound images in PCOS cases was constructed, and its diagnostic performance was evaluated.</p><p><strong>Results: </strong>Ultrasound images from 933 patients (781 from center 1 and 152 from center 2) were analyzed. The mean average precision of the YOLOv11 model in detecting the target ovary was 95.7%, 97.6%, and 97.8% for the training, internal validation, and external validation sets, respectively. For diagnostic classification, the model achieved an F1 score of 95.0% in the training set and 96.9% in both validation sets. The area under the curve values were 0.953, 0.973, and 0.967 for the training, internal validation, and external validation sets respectively. The model also demonstrated significantly faster evaluation of a single ovary compared to clinicians (doctor, 5.0 seconds; model, 0.1 seconds; <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>The YOLOv11-based automatic recognition model for PCOS ovarian ultrasound images exhibits strong target detection and diagnostic performance. This approach can streamline the follicle counting process in conventional ultrasound and enhance the efficiency and generalizability of ultrasound-based PCOS assessment.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"419-428"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815672","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 Rare <i>TERT</i> Mutation Associated with Idiopathic Pulmonary Fibrosis and COPD in a Chinese Family.","authors":"Liang-Liang Fan, Dong-Cai Feng, Jie-Yi Long, Ai-Qin Zhang","doi":"10.4274/balkanmedj.galenos.2025.2025-6-142","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-6-142","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a form of interstitial lung disease characterized by progressive lung scarring. It involves destruction of the alveolar architecture, thickening of the basement membrane, abnormal deposition of the extracellular matrix, inflammatory cell infiltration in the interstitial space, and formation of fibroblast foci. Mutations in <i>telomerase reverse transcriptase (TERT)</i> have been reported to be associated with IPF.</p><p><strong>Aims: </strong>To explore the genetic cause of a family affected by IPF and chronic obstructive pulmonary disease.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Whole-exome sequencing combined with IPF candidate gene filtering was used to identify the causative mutations. Sanger sequencing was applied to validate the mutation and perform c-segregation analysis. Real-time polymerase chain reaction (PCR) was conducted to analyze the telomere lengths of family members.</p><p><strong>Results: </strong>We identified a rare mutation, c.2669G > A (p. Gly890Asp), in <i>TERT</i> (NM_198253.2) in the proband and another affected family member. Bioinformatics analysis predicted this mutation to be deleterious, and structural modeling suggested that it altered the structure and surface charge distribution of the <i>TERT</i> protein. Additionally, real-time PCR demonstrated that mutation carriers had significantly shorter telomere lengths compared with individuals of the same age. According to American College of Medical Genetics and Genomics guidelines, this rare mutation was classified as likely pathogenic.</p><p><strong>Conclusions: </strong>This is the first reported case of IPF caused by the p. Gly890Asp mutation of <i>TERT</i> in the Chinese population. Our findings support the diagnosis of IPF in the patient and further highlight the role of <i>TERT</i> in the disease.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":"42 5","pages":"464-468"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940524","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":"Unsuspected Malaria Infection in a Case with Pancytopenia","authors":"Anjali Gupta, Shano Naseem","doi":"10.4274/balkanmedj.galenos.2025.2025-2-54","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-2-54","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"475-476"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149007","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":"Enhancing Shared Decision-Making in Cardiology with Artificial Intelligence","authors":"Vedat Cicek, Ulas Bagci","doi":"10.4274/balkanmedj.galenos.2025.2025-1-133","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-1-133","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"479-480"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955823","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":"Antioxidants: Current Summary","authors":"İlhami Gülçin","doi":"10.4274/balkanmedj.galenos.2025.2025.130825","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025.130825","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"388-392"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871179","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":"Recent Insights into the Epidemiology and Management of Anaphylaxis","authors":"Sakura Sato, Tsuyoshi Kodachi, Noriyuki Yanagida, Motohiro Ebisawa","doi":"10.4274/balkanmedj.galenos.2025.2025-5-86","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-5-86","url":null,"abstract":"<p><p>Anaphylaxis is a severe, rapidly developing systemic hypersensitivity reaction that can be life-threatening if not promptly identified and treated. Its global incidence is on the rise, especially among children, though fatal outcomes remain uncommon. This review summarizes the current understanding of anaphylaxis, covering its epidemiology, triggers, acute management, and strategies for long-term prevention, with emphasis on cases caused by food, medications, and insect stings.\u0000The estimated lifetime prevalence of anaphylaxis ranges from 0.05% to 2%. In children, food is the primary trigger, whereas in adults, medications are the most commonly responsible. The main culprits for food-related anaphylaxis differ by region: in Western countries, peanuts and tree nuts predominate; in East Asia, hen’s eggs and cow’s milk are most frequent; and in Southeast Asia, seafood is the leading cause. Drug-induced anaphylaxis-often the main cause of anaphylaxis-related deaths worldwide-is increasing due to the growing use of chemotherapies and biologic agents. Insect stings cause about 10% of all cases and remain the most common cause of fatal anaphylaxis.\u0000Intramuscular adrenaline continues to be the primary treatment, yet its administration is often delayed or insufficiently used. Patients should be prescribed adrenaline autoinjectors following an initial reaction, but availability and usage rates differ widely across countries. Education for patients and caregivers and the creation of clear action plans are essential. New alternatives, such as intranasal and sublingual adrenaline devices, are being developed to improve access and minimize hesitation in treatment. For prevention, VIT is well established and highly effective, preventing systemic reactions in over 90% of cases. Drug desensitization enables safe administration of necessary medications despite confirmed allergies, and this approach is suitable for all ages, including children. Oral immunotherapy for food allergens can increase tolerance levels and lower the chance of accidental exposure in selected patients, though safety concerns limit its widespread use.\u0000Biologic therapies like omalizumab present new treatment avenues for patients with multiple food or drug allergies. Recent studies have shown that omalizumab can raise the threshold for reactions to peanuts and other allergens in children. Case reports also indicate it may improve safety during drug desensitization, including for chemotherapy.\u0000Ongoing progress in diagnosis, emergency readiness, immunotherapies, and biologics continue to broaden the range of options for managing\u0000anaphylaxis. Nonetheless, gaps in access, awareness, and supporting\u0000evidence-particularly for children and older adults-underscore the need\u0000for additional research and health system investment.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"393-404"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726968","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":"Postoperative Pulmonary Complications: Clinical and Imaging Insights","authors":"Furkan Ufuk, İclal Ocak, Lydia Chelala, Luis Landeras","doi":"10.4274/balkanmedj.galenos.2025.2025-7.135","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-7.135","url":null,"abstract":"<p><p>Postoperative pulmonary complications (PPCs) continue to be a major cause of illness and death among surgical patients, affecting recovery and increasing healthcare expenses. This in-depth review examines the wide range of PPCs, covering infectious, inflammatory, mechanical, airway, vascular, lymphatic, and transplant-related issues. It highlights the vital function of imaging-especially computed tomography-in promptly identifying, correctly diagnosing, and managing these problems. Frequent complications like pneumonia, empyema, acute respiratory distress syndrome, atelectasis, and pulmonary embolism are covered, as well as rarer but serious conditions such as lung torsion, bronchopleural fistulas, and pseudoaneurysms. The review describes clinic signs and matches them with imaging characteristics to support diagnosis and treatment planning. It also underscores the value of a team-based approach involving surgeons, radiologists, and critical care experts to enable timely care and better patient results.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"405-418"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759030","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":"Onychopapilloma and Ungual Fibroma Revealing Late-Diagnosed Tuberous Sclerosis","authors":"Buğra Burç Dağtaş, Cem Leblebici","doi":"10.4274/balkanmedj.galenos.2025.2025-4-16","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-4-16","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"471-472"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706117","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":"The Associations of Dietary Copper and Magnesium Intake, Geriatric Nutritional Risk Index, and Systemic Inflammation Response Index with Stroke Risk in the Elderly","authors":"Baochun Luo, Sifan Liu, Lei Zheng, Baiwen Zhang, Wei Zou","doi":"10.4274/balkanmedj.galenos.2025.2025-7-25","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-7-25","url":null,"abstract":"<p><strong>Background: </strong>The effects of dietary copper and magnesium intake, the geriatric nutritional risk index (GNRI), and the systemic inflammation response index (SIRI) on stroke risk in the elderly remain unclear.</p><p><strong>Aims: </strong>To examine the relationships between dietary copper and magnesium intake, GNRI, SIRI, and stroke risk in the elderly.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Data from 7,157 elderly participants in National Health and Nutrition Examination Survey 2007-2016 were analyzed using multifactorial logistic regression, subgroup analysis, smooth curve fitting, threshold effect analysis, mediation analysis, and sensitivity analysis.</p><p><strong>Results: </strong>Higher dietary copper and magnesium intake were significantly and linearly associated with lower stroke risk. SIRI was positively associated with stroke risk, while GNRI had a stable protective effect. In fully adjusted models, medium- and high-level copper and magnesium intake were positively associated with GNRI and negatively associated with SIRI. GNRI mediated 4.4% and 5.5% of the associations between copper and magnesium intake and stroke risk, respectively; SIRI mediated 3.4% and 2.9%, respectively.</p><p><strong>Conclusion: </strong>Higher dietary copper and magnesium intake are associated with reduced stroke risk in the elderly, with GNRI and SIRI exerting modest mediating effects.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"452-463"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871181","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":"Crystalline Lens Extrusion Secondary to Fungal Keratitis","authors":"Suguru Nakagawa, Takashi Miyai, Kiyoshi Ishii","doi":"10.4274/balkanmedj.galenos.2025.2025-1-140","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-1-140","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"469-470"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662178","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}