Balkan Medical Journal最新文献

{"title":"Anti-Thyroglobulin Antibodies as a Surrogate Tumor Marker for the Follow-Up of the Differentiated Thyroid Carcinoma: Clinical Implications and Pitfalls.","authors":"Esra Eraslan Aydemir, Feride Özkara Akkuş, Murat Faik Erdoğan","doi":"10.4274/balkanmedj.galenos.2026.2026-3-145","DOIUrl":"10.4274/balkanmedj.galenos.2026.2026-3-145","url":null,"abstract":"<p><p>Antithyroglobulin antibodies (TgAb) are present in 10-25% of patients with differentiated thyroid cancer (DTC) and significantly affect the reliability of serum thyroglobulin (Tg) measurements during follow-up. Beyond causing assay interference, TgAb have emerged as independent surrogate tumor markers with prognostic implications. This review summarizes the current evidence on antithyroglobulin antibody biology, measurement methodologies, interference dynamics, and clinical utility as surrogate tumor markers in DTC surveillance. A narrative synthesis of the relevant English-language literature was performed, focusing on key clinical studies and recent guidelines. TgAb can lead to the underestimation of Tg levels in immunometric assays, potentially masking residual disease. Trend monitoring, rather than absolute antithyroglobulin antibody values, provides superior prognostic information; declining trends indicate favorable outcomes, whereas rising trends are associated with disease persistence or recurrence. <i>De novo</i> antithyroglobulin antibody positivity does not appear to serve as an early biomarker of recurrence. In antithyroglobulin antibody-positive patients, imaging-based surveillance, particularly neck ultrasonography, remains the cornerstone of follow-up. In conclusion, TgAb act as both interferents and surrogate tumor markers in DTC surveillance, and the integrated use of antithyroglobulin antibody trends and imaging is necessary for the optimal management of antithyroglobulin antibody-positive patients.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":"43 5","pages":"230-237"},"PeriodicalIF":4.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760787","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":"Ginkgetin Alleviates Doxorubicin-Induced Heart Failure by Regulating Mitochondrial Dysfunction Through the AMPK/Sirt1/NF-κB Signaling Pathway.","authors":"Yanfu Wang, Chong Wang, Wei Li, Xinyu Ren, Yubo Peng, Yan Zhang","doi":"10.4274/balkanmedj.galenos.2026.2025-11-113","DOIUrl":"10.4274/balkanmedj.galenos.2026.2025-11-113","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) represents the terminal stage of many cardiovascular diseases. Doxorubicin (DOX) can induce HF through oxidative stress (OS), inflammation, and apoptosis. Ginkgetin (GK) has potential cardioprotective effects, but its underlying mechanisms remain unclear.</p><p><strong>Aims: </strong>To investigate of GK against DOX-induced HF and explored its mechanisms, focusing on mitochondrial function and related signaling pathways.</p><p><strong>Study design: </strong><i>In vivo</i> and <i>in vitro</i> experimental models.</p><p><strong>Methods: </strong>HF was induced by DOX in mice and H9c2 cardiomyocytes. Cardiac function, myocardial injury, OS, inflammation, and apoptosis were assessed using echocardiography, biochemical assays, enzyme-linked immunosorbent assay, histopathology, immunofluorescence, and Western blot. Mitochondrial function was evaluated via transmission electron microscopy, RT-qPCR, and Seahorse analysis. Compound C was applied to verify the involvement of the adenosine monophosphate-activated protein kinase (AMPK)/Sirt1/nuclear factor-κB (NF-κB) pathway.</p><p><strong>Results: </strong>GK markedly improved DOX-induced cardiac dysfunction and myocardial injury, reduced cardiac injury markers and inflammatory cytokines, and alleviated fibrosis, hypertrophy, apoptosis, and reactive oxygen species accumulation. GK restored superoxide dismutase activity, decreased malondialdehyde levels, increased glutathione and ATP, and preserved mitochondrial structure and respiratory function. GK upregulated AMPK and Sirt1, inhibited NF-κB activation, and regulated apoptosis-related proteins, whereas Compound C reversed these effects.</p><p><strong>Conclusion: </strong>GK protects against DOX-induced HF by activating AMPK/Sirt1 and inhibiting NF-κB signaling, thereby mitigating OS, inflammation, apoptosis, and mitochondrial dysfunction.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"238-252"},"PeriodicalIF":4.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123451","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 Features, Laboratory and Radiological Findings, and Outcomes of <i>Pneumocystis jirovecii</i> Pneumonia in Immunocompetent Children.","authors":"Limei Wen, Li Huang, Junjie Ning","doi":"10.4274/balkanmedj.galenos.2025.10.40","DOIUrl":"10.4274/balkanmedj.galenos.2025.10.40","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"285-287"},"PeriodicalIF":4.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761624","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":"Cerebral Slow Flow: An Emerging Phenomenon in Vascular Dementia Pathogenesis.","authors":"Uğur Özkan, Fatih Kardaş, Umutcan Vurucu, Kenan Yalta","doi":"10.4274/balkanmedj.galenos.2025.2025-10-189","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-10-189","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"222-226"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666832","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 Novel Pathogenic Haplotype in <i>CDH23</i> Causing DFNB12: The Combined Effect of Two Individually Benign Variants","authors":"Zi-Xin Tian, Jun Zhang, Zi-Xuan Wang, Xi Song, Yi-Tao Zhou, Ying-Yi Hu","doi":"10.4274/balkanmedj.galenos.2026.2025-11-226","DOIUrl":"10.4274/balkanmedj.galenos.2026.2025-11-226","url":null,"abstract":"<p><strong>Background: </strong>Aberrations in cadherin-related 23 <i>(CDH23)</i> account for a significant proportion of familial autosomal recessive non-syndromic hearing loss (DFNB12), a common subtype of hereditary hearing loss worldwide.</p><p><strong>Aims: </strong>To elucidate the molecular basis and pathogenic mechanism of DFNB12 in an affected girl from a nine-member pedigree.</p><p><strong>Study design: </strong>Family-based genetic study with pedigree analysis.</p><p><strong>Methods: </strong>Clinical whole-exome sequencing combined with pedigree analysis was used to identify disease-causing mutations. The potential functional consequences of these mutations were investigated using structural bioinformatic approaches, including homology modeling, molecular dynamics simulations, and other relevant tools.</p><p><strong>Results: </strong>The proband carried compound heterozygous variants: a known pathogenic maternal variant (c.6049G > A) and a paternal haplotype comprising two linked variants (c.3262G > A and c.6911G > A), each individually classified as benign. Pedigree segregation analysis demonstrated that the paternal haplotype acts as a single pathogenic allele.</p><p><strong>Conclusion: </strong>Two individually benign variants can combine to form a novel pathogenic haplotype (c.3262A–c.6911A). This mechanism may be under-recognized in routine variant interpretation pipelines. Our findings underscore the importance of evaluating the combined effects of linked benign variants to ensure accurate genetic counseling.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"206-211"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083895","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":"Cold Contrast-Induced Coronary Slow Flow: A Preventable Pitfall in the Cath Lab.","authors":"Uzeyir Rahimov, Emin Karimli, Jamil Babayev","doi":"10.4274/balkanmedj.galenos.2025.2025-10-198","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-10-198","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"216-217"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713040","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, Radiologic, and Genetic Spectrum of Schimke Immuno-Osseous Dysplasia.","authors":"Mehtap Akbalık Kara, Beltinge Demircioğlu Kılıç, Mithat Büyükçelik, Ayşe Balat","doi":"10.4274/balkanmedj.galenos.2025.2025-10-27","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-10-27","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"218-221"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720890","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":"Genetic Influences on Disease-Modifying Therapy Response in Multiple Sclerosis: Current Insights and Future Directions.","authors":"Meziyet Dilara Reda, Aksel Siva, Eda Tahir Turanlı","doi":"10.4274/balkanmedj.galenos.2026.2026-1-153","DOIUrl":"10.4274/balkanmedj.galenos.2026.2026-1-153","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is a clinically and biologically heterogeneous, immune-mediated disease of the central nervous system, with substantial interindividual variability in disease course and response to disease-modifying therapies (DMTs). Over the past three decades, the MS therapeutic landscape has expanded considerably; however, treatment selection and switching remain guided primarily by clinical phenotype and imaging findings rather than molecular predictors of response. Despite extensive clinical trial evidence, prospectively identifying responders and non-responders to specific DMTs remains challenging. Genetic variability appears to influence differences in treatment efficacy, tolerability, and long-term outcomes in people with MS. Numerous candidate pharmacogenomic variants have been reported across interferon-β, glatiramer acetate, oral agents, and monoclonal antibodies; nevertheless, replication has been inconsistent, effect sizes are modest, and no genetic marker has yet been clinically validated for routine use. Consequently, pharmacogenomics is largely absent from current MS treatment algorithms. This review critically evaluates the existing pharmacogenomic literature across approved DMTs, highlighting reproducible findings, methodological limitations, and gaps that hinder clinical translation. We further discuss requirements for integrating pharmacogenomic markers into routine practice, emphasizing the need for large, multiethnic cohorts, standardized response definitions, and functional validation. Overall, these insights underscore both the potential and current limitations of pharmacogenomics in advancing precision medicine for MS.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":"43 4","pages":"174-182"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589539","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":"Direct Choledochoscopic Visualization of Living <i>Clonorchis sinensis</i> in the Biliary Tract.","authors":"Ma Zhili, Yuan Lei, Yang Xiaohong, Fan Ning, Wang Genshu","doi":"10.4274/balkanmedj.galenos.2025.2025-10-236","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-10-236","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"214-215"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951166","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":"Significance of LEF1, ROR2, Cyclin D1, and DNA Methylation Profiling in the Molecular Classification and Prognosis Prediction of Pediatric Medulloblastoma.","authors":"Mehmet Fatih Tekin, Dilek Gül, Nurşah Eker, Adnan Dağçınar, Yaşar Bayri, Fatih Bayraklı, Beste Melek Atasoy, Süheyla Uyar Bozkurt","doi":"10.4274/balkanmedj.galenos.2025.2025-10-51","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-10-51","url":null,"abstract":"<p><strong>Background: </strong>Accurate identification of medulloblastoma molecular subgroups is essential, particularly in settings lacking advanced genomic tools. Conventional markers, such as β-catenin, present significant challenges in reliably detecting the WNT-activated subgroup (WNT-AG).</p><p><strong>Aims: </strong>To evaluate the utility of lymphoid enhancer-binding factor 1 (LEF1), Cyclin D1, and receptor tyrosine kinase-like orphan receptor 2 (ROR2) as immunohistochemical (IHC) markers for molecular subgroup classification and to assess their prognostic significance.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>IHC analysis was performed using LEF1, Cyclin D1, and ROR2. Two distinct LEF1 staining patterns were identified: nuclear (nLEF1) and punctate (pLEF1). A subset of 29 cases, selected based on predefined criteria, underwent EPIC array Methylation analysis. Findings were correlated with recurrence and survival outcomes.</p><p><strong>Results: </strong>Among the 94 cases, 12.8% were WNT-AG, 54.3% were sonic hedgehog-activated subgroup (SHH-AG), and 33.0% were Groups 3 and 4 (G3/4). nLEF1 demonstrated higher specificity and sensitivity for WNT-AG than β-catenin, identifying it as a more reliable diagnostic marker. High pLEF1 expression was strongly associated with SHH-AG. Cyclin D1 positivity was predominantly observed in WNT-AG. While ROR2 did not identify WNT-AG effectively, its absence in Group 3 cases was notable. Prognostic analysis revealed that LEF1 expression patterns correlated with favorable survival outcomes: total LEF1 (tLEF1) and nLEF1 were associated with improved overall survival, whereas pLEF1 and tLEF1 were linked to better progression-free survival.</p><p><strong>Conclusion: </strong>Nuclear LEF1 (nLEF1) is at least as effective as β-catenin in identifying WNT-AG and may serve as a superior diagnostic marker. Cyclin D1 can be used as a complementary marker in WNT-AG detection. ROR2 negativity may indicate G3 tumors, though further studies are warranted to confirm its prognostic value.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"196-205"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951141","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}