{"title":"Bronchiectasis in Children: A Comparative Analysis of Cystic Fibrosis and Non-Cystic Fibrosis Etiologies Using the Bhalla Score","authors":"Handan Kekeç, Tuğba Şişmanlar Eyüboğlu, Ayse Tana Aslan, Yasemin Duman, Volkan Medeni, Merve Yazol, Öznur Leman Boyunağa","doi":"10.4274/balkanmedj.galenos.2025.2025-6-247","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-6-247","url":null,"abstract":"<p><strong>Background: </strong>Childhood bronchiectasis (BE) is a chronic lung condition that remains under recognized, marked by irreversible widening of the bronchi, frequent respiratory infections, a persistent wet cough, and progressive lung damage, often leading to significant health burdens.</p><p><strong>Aims: </strong>To evaluate children with cystic fibrosis (CF) and non-CF BE and to examine the association between clinical presentation and radiological severity of BE using the Bhalla scoring system.</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>Children aged 0-18 years with a CT-confirmed diagnosis of BE were enrolled. Data on demographics, clinical characteristics, and imaging results were collected retrospectively from medical records. The Bhalla score was used to assess BE severity. Patients were categorized into CF-related and non-CF BE groups. The two groups were compared with respect to clinical features, growth z-scores, hospitalization frequency, and pulmonary function test outcomes.</p><p><strong>Results: </strong>A total of 157 patients were analyzed. Among them, CF accounted for 23.6% of cases, and while the leading causes in the non-CF group were post-infectious BE (28%), immunodeficiency (19.8%), and primary ciliary dyskinesia (12.8%). The CF group presented at an earlier age, had a longer follow-up period, and experienced more frequent hospitalizations (<i>p</i> < 0.001). In the CF group, weight, height, and body mass index z-scores significantly improved from the initial to the final assessment (<i>p</i> = 0.010, <i>p</i> = 0.006, and <i>p</i> = 0.026, respectively), whereas no such improvement was observed in the non-CF group. Severe Bhalla scores were more frequently observed in the CF group (p < 0.001). Among CF patients, Bhalla scores showed a strong correlation with forced expiratory volume in one second (FEV<sub>1</sub>) in univariate analysis (r = 0.846, <i>p</i> < 0.001), though this was not significant in multivariable analysis (<i>p</i> = 0.434). In the non-CF group, there was no correlation between Bhalla scores and final FEV<sub>1</sub> values (<i>p</i> = 0.148, r = 0.212).</p><p><strong>Conclusion: </strong>The results underscore distinct clinical trajectories between CF and non-CF BE in children. Improvements in CF patients suggest the effectiveness of structured clinical management, whereas inconsistent outcomes in non-CF patients point to the need for standardized follow-up protocols. While the Bhalla score may indicate the extent of structural lung disease in CF, it does not independently predict lung function, and therefore should be used as a supplementary, not solitary, measure of disease severity.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":"42 5","pages":"429-439"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940542","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}
Balkan Medical JournalPub Date : 2025-09-01Epub Date: 2025-05-07DOI: 10.4274/balkanmedj.galenos.2025.2025-2-33
Ercan Akşit, Gökay Taylan, Uğur Küçük, Bahadır Kırılmaz
{"title":"Myocardial Venous Bridge: Images of the First Cases Detected by Conventional Angiography and Venography","authors":"Ercan Akşit, Gökay Taylan, Uğur Küçük, Bahadır Kırılmaz","doi":"10.4274/balkanmedj.galenos.2025.2025-2-33","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-2-33","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"485-486"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955738","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}
Balkan Medical JournalPub Date : 2025-09-01DOI: 10.4274/balkanmedj.galenos.2025.2025-7-262
Jun Liang, Yun Bai, Huan Zhao
{"title":"Inhibition of PI3K and Hedgehog Signaling Pathway Inhibits Hypoxia-Induced Vasculogenic Mimicry Formation in Ovarian Cancer Stem Cells.","authors":"Jun Liang, Yun Bai, Huan Zhao","doi":"10.4274/balkanmedj.galenos.2025.2025-7-262","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-7-262","url":null,"abstract":"<p><strong>Background: </strong>Inhibition of the Hedgehog and phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathways has been shown to suppress tumor proliferation and stem cell activity. However, the precise role of these pathways in vasculogenic mimicry (VM) of ovarian cancer stem cells (OCSCs) remains unclear.</p><p><strong>Aims: </strong>To investigate the roles of the PI3K/AKT and Hedgehog signaling pathways in VM formation and the underlying mechanisms in OCSCs.</p><p><strong>Study design: </strong><i>In vitro</i> and <i>in vivo</i> experimental model.</p><p><strong>Methods: </strong>OCSCs were induced through serum-free culture of SK-OV-3. Hypoxia-inducible factor-1α (HIF-1α) knockdown was achieved by transfection with sh-HIF-1α. Cells were treated with the PI3K agonist 740 Y-P, the PI3K inhibitor LY294002, the Hedgehog agonist purmorphamine, and the Hedgehog inhibitor cyclopamine under hypoxic conditions. Expression of HIF-1α, epithelial-to-endothelial transition (EET) markers, and components of the PI3K and Hedgehog pathways was analyzed using immunofluorescence and Western blotting. VM capacity was assessed using a Matrigel three-dimensional (3D) culture assay. Cell proliferation and invasion were evaluated by MTS, EdU, and Transwell assays. VM formation was further examined in an OCSC xenograft model.</p><p><strong>Results: </strong>OCSCs accounted for more than 85% of seventh-generation SK-OV-3 cells cultured under serum-free conditions. Hypoxia markedly increased HIF-1α expression, which activated the PI3K and Hedgehog signaling pathways. HIF-1α knockdown suppressed activation of these pathways. Treatment with LY294002 and cyclopamine, as well as HIF-1α knockdown, inhibited hypoxia-induced upregulation of N-cadherin and VE-cadherin, as well as the formation of branching points and 3D channels. Moreover, both LY294002 and cyclopamine significantly reduced cell proliferation, invasion, and VM formation in vitro and in xenografted OCSCs.</p><p><strong>Conclusion: </strong>HIF-1α knockdown inhibits activation of the PI3K and Hedgehog signaling pathways, thereby reducing EET and VM formation in hypoxia-induced OCSCs.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":"42 5","pages":"440-451"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940557","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}
Balkan Medical JournalPub Date : 2025-09-01Epub Date: 2025-03-24DOI: 10.4274/balkanmedj.galenos.2025.2024-12-133
Damien Gruson, Tuğba Kemaloğlu Öz
{"title":"Trends in Healthcare and Laboratory Medicine: A Forward Look into 2025","authors":"Damien Gruson, Tuğba Kemaloğlu Öz","doi":"10.4274/balkanmedj.galenos.2025.2024-12-133","DOIUrl":"10.4274/balkanmedj.galenos.2025.2024-12-133","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"487-488"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690997","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}
Balkan Medical JournalPub Date : 2025-09-01Epub Date: 2025-05-07DOI: 10.4274/balkanmedj.galenos.2025.2025-1-132
Mostafa Saadat
{"title":"Impact of Smoking on SARS-CoV-2 Infection and Outcomes, An Evidence from Enrichment Analysis of Genes Associated with COVID-19 Susceptibility and Outcomes","authors":"Mostafa Saadat","doi":"10.4274/balkanmedj.galenos.2025.2025-1-132","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-1-132","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"477-478"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963347","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}
Balkan Medical JournalPub Date : 2025-09-01Epub Date: 2025-05-16DOI: 10.4274/balkanmedj.galenos.2025.2025-2-27
Gizem Yağmur Değirmenci
{"title":"Assessment of School Readiness: A Health-Based Multidisciplinary Model for Türkiye","authors":"Gizem Yağmur Değirmenci","doi":"10.4274/balkanmedj.galenos.2025.2025-2-27","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-2-27","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"489-490"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075690","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}
Balkan Medical JournalPub Date : 2025-09-01Epub Date: 2025-08-11DOI: 10.4274/balkanmedj.galenos.2025.2025-4-32
Aasiya Shahbaz Sakarwala, Noor Ul Ain Shahzad, Manahil Mubeen
{"title":"Applications of mRNA-Based Therapies in Oncology and Autoimmunity Beyond Vaccination","authors":"Aasiya Shahbaz Sakarwala, Noor Ul Ain Shahzad, Manahil Mubeen","doi":"10.4274/balkanmedj.galenos.2025.2025-4-32","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-4-32","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"481-484"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815673","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}
Balkan Medical JournalPub Date : 2025-09-01Epub Date: 2025-08-11DOI: 10.4274/balkanmedj.galenos.2025.2025.040825
Selçuk Korkmaz
{"title":"Statistical Rigor and Reproducibility in the AI Era","authors":"Selçuk Korkmaz","doi":"10.4274/balkanmedj.galenos.2025.2025.040825","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025.040825","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"386-387"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815674","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}
Balkan Medical JournalPub Date : 2025-08-29DOI: 10.4274/balkanmedj.galenos.2025.2025-6-239
Elif Er Gülbezer, Oğuz Usta, Deniz Güllü, Şiran Keske, Önder Ergönül
{"title":"Misdiagnosed Lyme: A Multidisciplinary Case Series from a Non-Endemic Region.","authors":"Elif Er Gülbezer, Oğuz Usta, Deniz Güllü, Şiran Keske, Önder Ergönül","doi":"10.4274/balkanmedj.galenos.2025.2025-6-239","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025-6-239","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940439","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}
Balkan Medical JournalPub Date : 2025-08-26DOI: 10.4274/balkanmedj.galenos.2025.2025-8-9
Malek Bouhani, Salma Kamoun
{"title":"Extranodal Rosai-Dorfman Disease of the Breast Presenting as Inflammatory Breast Cancer: A Rare Diagnostic Challenge.","authors":"Malek Bouhani, Salma Kamoun","doi":"10.4274/balkanmedj.galenos.2025.2025-8-9","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2025.2025-8-9","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940427","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}