Balkan Medical Journal最新文献

{"title":"Pulmonary Sequestration with a Descending Aorta-Sized Aberrant Artery.","authors":"Gaku Yamaguchi","doi":"10.4274/balkanmedj.galenos.2026.2026-2-56","DOIUrl":"10.4274/balkanmedj.galenos.2026.2026-2-56","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"402-403"},"PeriodicalIF":4.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324613","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":"Reduction in Albuminuria with Dapagliflozin Exhibits Substantial Interindividual Variability: A Real-World Study Utilizing a Big Data Approach.","authors":"Jinfang Song, Yongru Zhuang, Chenling Wu, Yi Xu, Ya Chen, Tao Wang, Xiaoxing Yin, Fen Xie","doi":"10.4274/balkanmedj.galenos.2026.2025-12-261","DOIUrl":"10.4274/balkanmedj.galenos.2026.2025-12-261","url":null,"abstract":"<p><strong>Background: </strong>Differences in the albuminuria-lowering effect of dapagliflozin and the associated factors require further exploration.</p><p><strong>Aims: </strong>To evaluate interindividual variability in the albuminuria-lowering effect of dapagliflozin and identify factors associated with the albuminuria response to dapagliflozin.</p><p><strong>Study design: </strong>Retrospective observational cohort study.</p><p><strong>Methods: </strong>This real-world study, utilizing a big data approach, included patients diagnosed with type 2 diabetic kidney disease (T2DKD) who received dapagliflozin treatment for a minimum of 3 months. Using the change in urinary albumin-creatinine ratio (UACR) after 3 months of dapagliflozin treatment as the primary surrogate endpoint, patients with a UACR reduction of > 30% were categorized as responders, whereas the remaining patients were classified as non-responders. Logistic regression analysis was conducted to explore factors affecting the albuminuria response to dapagliflozin, and receiver operating characteristic (ROC) curves were plotted to evaluate the discriminative ability of the associated factors.</p><p><strong>Results: </strong>Among 10,860 patients with T2DKD, 4,487 (41.32%) were classified as non-responders to dapagliflozin. Logistic regression analysis identified the duration of T2DM (<i>p</i> < 0.001), baseline hemoglobin A1c (HbA1c) (<i>p</i> = 0.002), baseline systolic blood pressure (SBP, <i>p</i> = 0.004), and baseline UACR (<i>p</i> < 0.001) as factors associated with the albuminuria response to dapagliflozin. The areas under the ROC curve for baseline HbA1c, baseline SBP, baseline UACR, duration of T2DM, and the combination of these four factors in assessing the efficacy of dapagliflozin in lowering albuminuria were 0.508, 0.531, 0.563, 0.603, and 0.646, respectively.</p><p><strong>Conclusion: </strong>Significant interindividual variability was observed in the albuminuria-lowering effect of dapagliflozin in the Chinese population. After adjustment for potential confounders, the duration of T2DM, baseline HbA1c, baseline SBP, and baseline UACR were identified as factors associated with the albuminuria response to dapagliflozin. However, their discriminative ability was limited and inadequate for clinical use according to the ROC analysis.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"372-382"},"PeriodicalIF":4.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589536","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 Blood Cyst with Calcification Located in the Right Atrium.","authors":"Leizhi Ku, JiaJia Lu, Xiaojing Ma","doi":"10.4274/balkanmedj.galenos.2026.2026-3-153","DOIUrl":"https://doi.org/10.4274/balkanmedj.galenos.2026.2026-3-153","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142570","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":"A Case of Submandibular Ectopic Parathyroid Adenoma: Diagnostic Challenges and Clinical Insights.","authors":"Wei Yang, Yusheng Ye, Liangyu Gan","doi":"10.4274/balkanmedj.galenos.2026.2025-12-248","DOIUrl":"10.4274/balkanmedj.galenos.2026.2025-12-248","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"355-356"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146148983","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":"Half-and-Half Nails and Terry's Nails: Distinct Nail Manifestations of the Same Underlying Chronic Kidney Disease.","authors":"Marta Szepietowska, Bartosz Lisicki, Andrzej K Jaworek, Magdalena Krajewska, Jacek C Szepietowski","doi":"10.4274/balkanmedj.galenos.2026.2026-1-208","DOIUrl":"10.4274/balkanmedj.galenos.2026.2026-1-208","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"343-344"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206710","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":"Digital Health and Remote Patient Monitoring in Heart Failure: From Pathophysiology to Value-Based Care in Emerging Health Systems.","authors":"Ulvi Mirzoyev, Cecilia Linde, Thomas F Lüscher","doi":"10.4274/balkanmedj.galenos.2026.2026-1-250","DOIUrl":"10.4274/balkanmedj.galenos.2026.2026-1-250","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"347-350"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147301478","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 Strong Get Stronger: The Matthew Effect in Academic Publishing.","authors":"Selçuk Korkmaz, Servet Altay","doi":"10.4274/balkanmedj.galenos.2026.2026.150426","DOIUrl":"10.4274/balkanmedj.galenos.2026.2026.150426","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":"43 6","pages":"294-296"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136372","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 Global Burden of Chronic Kidney Disease Attributable to Hypertension in Young Adults From 1990 to 2021 and Projections to 2050.","authors":"Li He, Pengcheng Yan, Cheng Liu, Xiangde Zheng, Minming Zheng, Qingwei Chen","doi":"10.4274/balkanmedj.galenos.2026.2026-1-54","DOIUrl":"10.4274/balkanmedj.galenos.2026.2026-1-54","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) attributable to hypertension represents a major global public health challenge. This study evaluates the global burden of CKD statistically attributable to high systolic blood pressure (SBP), with a focus on young adults aged 25-49 years.</p><p><strong>Aims: </strong>To analyze trends in mortality and disability-adjusted life years (DALYs) attributable to high SBP among individuals with CKD aged 25-49 years from 1990 to 2021 and to project the future attributable burden through 2050.</p><p><strong>Study design: </strong>Observational study.</p><p><strong>Methods: </strong>Data were obtained from the Global Burden of Disease Study 2021. The analysis estimated the burden of CKD attributable to high SBP using a comparative risk assessment framework. Temporal trends were quantified using the estimated annual percentage change (EAPC). The association between attributable burden and the sociodemographic index (SDI) was also examined. Projections to 2050 were generated using autoregressive integrated moving average models.</p><p><strong>Results: </strong>From 1990 to 2021, global mortality and DALY rates for CKD attributable to high SBP among young adults increased significantly (mortality EAPC, 1.75%; DALYs EAPC, 1.6%). The attributable burden remained consistently higher in males and increased with age, peaking in the 45-49-year age group. Overall, low- and low-middle-SDI regions experienced the greatest relative increases, although substantial heterogeneity was observed within SDI strata. At the national level, Ukraine showed the largest increase in mortality rate (EAPC, 13.21%), whereas the Republic of Korea exhibited the largest decline (EAPC, -4.68%). Model-based projections suggest a continued increase in both attributable mortality and DALYs through 2050, with persistent disparities by sex, age, and geographic region.</p><p><strong>Conclusion: </strong>The burden of CKD attributable to high SBP among young adults has increased substantially over the past three decades and is projected to rise further, reflecting persistent global inequalities. These findings highlight the urgent need for strengthened and targeted strategies for hypertension prevention and management in younger populations worldwide.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"309-321"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589532","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":"Rheumatoid Arthritis Burden in Middle-Aged Adults (40-59 Years): Evidence from the Global Burden of Disease 2021.","authors":"Meng Zhao, Jing Shi, Xiaohui Sun, Hongfei Ma, Huimin Yin, Yangyang Liu, Pingmin Wei","doi":"10.4274/balkanmedj.galenos.2026.2025-12-228","DOIUrl":"10.4274/balkanmedj.galenos.2026.2025-12-228","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a leading cause of disability worldwide. Although global assessments of RA have been reported, age-specific estimates focusing on middle-aged adults [(MAA); 40-59 years] remain limited.</p><p><strong>Aims: </strong>To quantify the global, regional, and temporal burden of RA among MAA from 1990 to 2021 and project age-standardized trends through 2050.</p><p><strong>Study design: </strong>A population-based descriptive epidemiological study using Global Burden of Disease (GBD) 2021 estimates.</p><p><strong>Methods: </strong>GBD 2021 data (1990-2021) were used to estimate age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life-year rates (ASDR) per 100,000 population among MAA. Temporal trends were assessed using joinpoint regression and expressed as the average annual percentage change (AAPC). Projections to 2050 were generated using a Bayesian age-period-cohort model. Burden patterns were summarized across sociodemographic index (SDI) quintiles and 21 GBD regions.</p><p><strong>Results: </strong>In 2021, the global ASIR, ASPR, ASMR, and ASDR among MAA were 19.53, 368.73, 0.19, and 56.74 per 100,000 population, respectively. From 1990 to 2021, ASIR and ASPR increased (AAPC = 0.24% and 0.43%), ASMR decreased (AAPC = -1.70%), and ASDR showed minimal net change (AAPC = 0.05%). Substantial variation was observed across SDI quintiles and GBD regions; SDI was positively correlated with ASIR and ASPR and negatively correlated with ASMR. Projections to 2050 indicated an ASIR of 19.22, an ASPR of 367.47, an ASMR of 0.111, and an ASDR of 52.18 per 100,000, with widening credible intervals over time.</p><p><strong>Conclusion: </strong>Between 1990 and 2021, the RA burden among MAA was characterized by increasing ASIR and ASPR, declining ASMR, and relatively stable ASDR. Projections suggest that ASIR and ASPR will remain near recent levels, whereas ASMR and ASDR will show lower median values over time.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"322-329"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497373","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":"Complementary ROC-Derived Indices for Screening Improper Expression Profiles in RNA-Seq Differential Expression Analysis.","authors":"Merve Başol Göksülük, Ebru Öztürk, Ünal Erkorkmaz, Asuman Deveci Özkan, Hamdi Furkan Kepenek, Dinçer Göksülük","doi":"10.4274/balkanmedj.galenos.2026.2026-1-309","DOIUrl":"10.4274/balkanmedj.galenos.2026.2026-1-309","url":null,"abstract":"<p><strong>Background: </strong>Differential expression (DE) analysis of RNA sequencing (RNA-Seq) data are cornerstone of transcriptomic research. Widely used statistical frameworks are primarily optimized to detect monotonic mean shifts between conditions and may therefore overlook genes or microRNAs whose disease association arises at both low and high expression levels. Such non-monotonic patterns, referred to here as improper expression profiles, may reflect biologically relevant heterogeneity but remain difficult to identify using standard tools.</p><p><strong>Aims: </strong>To evaluated whether receiver operating characteristic (ROC)-based indices, specifically the generalized area under the curve (gAUC) and the length of the ROC curve (LROC), can support exploratory screening and prioritization of improper expression profiles in RNA-Seq data, as a complement to conventional DE methods.</p><p><strong>Study design: </strong>Methodological study.</p><p><strong>Methods: </strong>Using simulated negative binomial count data, we compared DESeq2, classical AUC (cAUC), gAUC, and LROC across varying sample sizes and dispersion levels, focusing on improper expression profiles. Performance was summarized using true positive rate and positive predictive value under ranking-based feature selection, including a one-shot benchmark operating point (available only in simulations) and sensitivity analyses across selection sizes. The methods were also applied to a publicly available CC miRNA dataset using heuristic post-hoc screening rules informed by simulation diagnostics.</p><p><strong>Results: </strong>cAUC was largely insensitive to improper expression patterns. DESeq2 performed robustly for conventionally differentially expressed features but recovered a smaller fraction of simulated improper profiles under ranking-based selection. Across simulation scenarios, gAUC showed the highest and most stable recovery of improper profiles, whereas LROC provided complementary signal under low-to-moderate dispersion but degraded under extreme overdispersion. In the CC dataset, ROC-derived indices identified candidate improper miRNAs that were not prioritized by DESeq2, and several top candidates had literature support consistent with biological plausibility.</p><p><strong>Conclusion: </strong>gAUC, supported by LROC as an auxiliary index, provides a practical ROC-based screening extension to standard RNA-Seq workflows. Because these indices are applied using heuristic thresholds without controlled error rates, the resulting candidates should be interpreted as exploratory prioritization and require independent validation.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":"43 6","pages":"330-342"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136404","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}