Medical Sciences Commons^™

3d Em Uncovers Mitochondrial Network Remodeling In Residual Triple Negative Breast Cancer After Conventional Chemotherapy Treatments, Mariah J Berner, Heather K Beasley, Benjamin Rodriguez, Audra Lane, Steven W Wall, Andrea G Marshall, Zer Vue, Larry Vang, Mokryun L Baek, Mason Killion, Faben Zeleke, Bryanna Shao, Dominique Parker, Autumn Peterson, Julie Sterling Rhoades, Lacey E Dobrolecki, Amber Crabtree, Annet Kirabo, Sepiso K Masenga, Prasanna Katti, Prasanna Venkhatesh, Chandravanu Dash, Michael T Lewis, Antentor Hinton, Gloria V Echeverria

Faculty, Staff and Students Publications

Mitochondria are hubs of metabolism and signaling. We previously demonstrated the importance of mitochondrial structure and function in chemotherapy-refractory triple-negative breast cancer (TNBC). Herein, we present the first 3D analysis of mitochondrial networks in human tumor tissues. Using serial block face scanning electron microscopy, we reconstructed 3,750 mitochondria and 800 lipid droplets (LDs) in naive and residual tumors persisting after conventional chemotherapies in two orthotopic patient-derived xenografts (PDX). Chemotherapies administered as monotherapy or in combination produced residual tumors that harbored mitochondria with significantly increased areas, volumes, and perimeters. We observed substantial reduction of mitochondrial intratumor heterogeneity following all treatments. Further, …

Targeting Arginine Metabolism Overcomes Chemotherapy Resistance In Aggressive-Variant Prostate Cancers, Elavarasan Subramani, Patrick G Pilié, Rebecca Slack-Tidwell, Paul V Viscuse, Xianghong Kuang, Thirukumaran Kandasamy, Dominik Awad, Jenny J Han, Licai Huang, Christine B Peterson, Amado J Zurita, Sumit K Subudhi, Paul G Corn, Rama Soundararajan, Peter Shepherd, Badrajee Piyarathna, Vasanta Putluri, Nagireddy Putluri, Arun Sreekumar, Yuzhuo Wang, Amina Zoubeidi, Iqbal Mahmud, Sara A Martinez, Lin Tan, Philip L Lorenzi, Sreyashi Basu, Sonali Jindal, Padmanee Sharma, Christopher J Logothetis, Timothy C Thompson, Daniel E Frigo, Ana M Aparicio

Faculty, Staff and Students Publications

Aggressive-variant prostate cancers (AVPCs) respond poorly to anti-androgen therapy but show sensitivity to taxane-platinum chemotherapy, though outcomes remain poor. We conducted a phase 2 trial testing induction cabazitaxel plus carboplatin (CabCarb) followed by olaparib maintenance versus observation in men with AVPC. The primary endpoint of improved progression-free survival (PFS) was not met, likely due to the study being underpowered after 38.5% of patients experienced early progression (ChemoPD) prior to randomization. No genomic alterations predicted ChemoPD; however, transcriptomic analysis revealed the enrichment of metabolic pathways, including arginine metabolism, in ChemoPD tumors. These findings were supported by metabolomics data from preclinical models. …

Targeted Inhibition Of Atr Kinase Promotes Antitumor Immunity In Hnscc Through Enhanced Sting Activation And T Cell Function, Fabio Hb Da Costa, Mutsuki Kawabe, Tsung-You Tsai, Kento Okamoto, Mason D Bartels, Sofia Cortes, Ratna Veeramachaneni, Roberto Rangel, Mitchell J Frederick, Vlad C Sandulache, Andrew G Sikora, Jeffrey N Myers, Abdullah A Osman

Faculty, Staff and Students Publications

Objectives: Oral cavity head and neck squamous cell carcinoma (HNSCC) represents a major global health burden, with over 40,000 new cases annually in the United States and >500,000 worldwide. Despite advances in surgery, radiation therapy, chemotherapy, and immunotherapy, overall survival rates have remained largely stagnant over the past three decades, and over half of patients ultimately die from the disease. Although immune checkpoint inhibitors (ICIs) have improved outcomes for a subset of patients with recurrent or metastatic HNSCC, the majority gain limited benefit. Thus, novel therapeutic strategies that enhance responses to immunotherapy are urgently needed. The ATR-CHK1 signaling pathway has …

Neddylation Maintains Oocyte Quality By Stabilizing Mitochondrial Transcription, Avery A Ahmed, Tessa E Steenwinkel, Bethany K Patton, Peixin Jiang, Matthew D Meyer, Jaspreet K Rishi, Mei Leng, Alexander B Saltzman, Elizabeth S Anaya, Momal Sharif, Laurie J Mckenzie, Laura Detti, Anna Malovannaya, Sean M Hartig, Stephanie A Pangas

Faculty, Staff and Students Publications

Age-related decline in oocyte quality increases the risk of infertility, miscarriage, and birth defects. Mitochondrial dysfunction is a key contributor to this decline. Here, we report that oocyte-specific deletion of Uba3, which encodes the catalytic subunit of the E1 NEDDylation-activating complex, causes sterility in mice. Fully grown, germinal vesicle–stage Uba3 conditional knockout oocytes exhibit mitochondrial dysfunction, including elevated reactive oxygen species, impaired oxidative phosphorylation, and depletion of mitochondrially encoded RNA transcripts. Proteomic analysis identified alterations in mitochondrial-associated proteins, including enrichment of mitochondrial matrix and respiratory chain components and reduced abundance of electron transport chain complexes. These defects were associated …

The Role Of 14-3-3 Proteins In The Pro-Inflammatory Response Of Microglia And The Neuronal Stress Response To Trichloroethylene Exposure, William Stone

ETDs from 2020-2029

ABSTRACT This dissertation examines how 14-3-3 proteins, with a focus on the 14-3-3θ iso-form, regulate signaling pathways relevant to neurodegeneration. While tradition-ally described as molecular hubs that organize protein–protein interactions, our work reveals how 14-3-3 function is shaped by environmental insults, namely bac-terial and neurotoxicant exposures, and how its disruption contributes to disease-associated processes. Two complementary approaches were used, focusing on microglial inflammatory signaling and neuronal responses to an environmental neurotoxicant, to define a broader role for 14-3-3 proteins in disease associated pathways in the brain. Chapter I identifies 14-3-3 proteins as modulators of microglial activation. Disrup-tion of 14-3-3 interactions …

Macrophages As Gatekeepers Of Glioma Progression, Cliona M Rooney, Jasia Mahdi

Faculty, Staff and Students Publications

No abstract provided.

Fibulin-4 Expressed In Metastatic Breast Cancer Is A Target Of Peptide-Based Imaging Probes And Experimental Therapeutics, Alexes C Daquinag, Sukhen C Ghosh, Solmaz Aghaamiri, Stephen M Farmer, Sheng Zhang, Servando Hernandez Vargas, Ashwin K Ramesh, Zhiqiang An, Ali Azhdarinia, Mikhail G Kolonin

The Brown Foundation: Institute of Molecular Medicine

There is a lack of approaches to detect and kill metastatic cells. As an agent for metastasis targeting, a cyclic peptide BLMP6 has been previously characterized. As a step toward translation, we designed AZDye555-labeled BLMP6 and demonstrated its homing to metastases of human MDA-MB-231 cells in mice. We show that 68Ga-radiolabeled BLMP6 can be used for the detection of MDA-MB-231 metastases. We designed a peptide-drug conjugate consisting of monomethyl auristatin E (MMAE) and BLMP6. We show that MMAE-BLMP6 kills MDA-MB-231 cells in cell culture and in vivo. In mouse models of lung metastases, treatment with MMAE-BLMP6 suppressed metastasis growth …

The Association Of Daily Urinary And Bowel Incontinence With Emotional Functioning In Young Adults With Spina Bifida: An Ecological Momentary Assessment Study, Audrey I. Young '26, Devon J. Hensel, Konrad M. Szymanki

Student Research

Many young adults with spina bifida experience bladder and bowel leakage, but clinic visits often rely on people remembering and summarizing their symptoms over long periods. In this study, we asked participants to report their experiences each day for one month using simple phone-based check-ins. We found that leakage does not affect every day in the same way. On days when symptoms were more frequent or harder to manage, participants reported worse mood, more worry, and were more likely to avoid activities. These day-to-day experiences also related to over- all quality of life at the end of the month. For …

Management Algorithm For Vasoplegic Shock After Cardiac Surgery: An Interdisciplinary Collaboration, Subhasis Chatterjee, Jamel Ortoleva, Rakesh C Arora, Kelci R Dalton, Daniel T Engelman, Natalia Ivascu Girardi, Michael C Grant, Travis J Miles, Marc R Moon, Orlando R Suero, Erica Wittwer, Patrick M Wieruszewski

Faculty, Staff and Students Publications

Background: Vasoplegic shock is distributive shock that follows cardiopulmonary bypass, characterized by hypotension, low systemic vascular resistance, and catecholamine resistance despite preserved or elevated cardiac output. Reported incidence ranges from 5% to 50%. Associated adverse outcomes include acute kidney injury, prolonged intensive care unit stay, and mortality. A single, universally accepted consensus definition is lacking, and few evidence-based best-practice management strategies exist.

Methods: A panel of 12 clinicians-cardiac surgeons, anesthesiologists, intensivists, and pharmacists-from 6 institutions conducted a structured expert review. PubMed and Embase were searched for research studies, including clinical trials, retrospective analyses, and mechanistic studies covering epidemiology, risk factors, …

Placenta Accreta Spectrum Risk In Endometriosis: A Retrospective Cohort Study With Art Subanalysis, Madeline West, Amir Alsaidi, Michael A Belfort, Hendrik A Lombaard, Yamely H Mendez, Christina C Reed, Amir A Shamshirsaz, Jessian L Munoz

Faculty, Staff and Students Publications

No abstract provided.

Detection, Persistence, And Rising Prevalence Of Oncogenic Viruses Revealed By Wastewater Metagenomics, Harihara Prakash, Ryan K Perez, Matt Ross, Michael Tisza, Sara J Javornik Cregeen, Jennifer Deegan, Joseph F Petrosino, Eric Boerwinkle, Justin R Clark, Anthony W Maresso

Faculty, Staff and Students Publications

Oncogenic viruses cause high-risk cancers in humans and are responsible for nearly 20% of all cancer cases worldwide. Currently, very limited data exist in the realm of wastewater-based viral epidemiology (WBE) for cancer-causing viruses, with existing studies using targeted approaches (i.e., PCR-based approaches) that lack genomic resolution. In this study, we used a hybrid-capture approach to detect, filter, and sequence all known oncogenic virus signals from wastewater samples collected over 3 years (May 2022-May 2025) in 16 Texas cities, covering nearly 25% of the state's population. Once sequenced, we used custom computational tools designed for wastewater metagenomics to assign reads …

Anatomy And Function Of Vasopressin Receptor 1a-Expressing Neurons In The Limbic Thalamus, David Joseph Kahn

Theses and Dissertations

The vasopressin (Avp) system modulates social behavior through region-specific and sex-dependent mechanisms, yet the role of Avp receptor 1a (Avpr1a) signaling in the thalamus has remained largely unexplored. This dissertation examined the distribution and functional contributions of Avpr1a-expressing neurons across the mouse thalamus using a combination of genetic labeling, anatomical quantification, and chemogenetic manipulation. Mapping of Avpr1a-expressing neurons revealed a presence in most thalamic nuclei, with highest densities in the anterior thalamic nuclei and midline nuclei. Notably, Avpr1a-expressing neuron densities did not mirror previously described patterns of Avp innervation, and no sex differences in Avpr1a-expressing neuron density were observed. Chemogenetic …

The Role Of Mitochondrial And Lysosomal Damage In Neurotoxicity From Parkinson 'S-Related Environmental Exposures, Neda Ilieva

ETDs from 2020-2029

Parkinson's disease (PD) is a progressive motor neurodegenerative disorder with a predominantly idiopathic etiology. More recently, however, the contribution of exogenous risk factors such as environmental contaminants has become of interest. Some endogenous genetic risk factors have been well characterized, but the mechanisms by which exogenous insults, such as environmental contaminants, drive dopaminergic neurodegeneration remain incompletely understood. This dissertation will address how environmental contaminants converge on mitochondrial and lysosomal dysfunction to activate parallel neurotoxic signaling pathways, with a focus on the LRRK2 kinase and the cGAS-STING innate immune pathway. Chapter 2 demonstrates that pharmacological inhibition of LRRK2 kinase activity protects …

Hla Allele And Haplotype Diversity In Central Anatolia: A Comparative Analysis Of Donors And Transplant Candidates Across Six Hla Loci (Hla-A, Hla-B, Hla-C, Hla-Drb1, Hla-Dqb1, And Hla-Dpb1), Emel Yantir, Eren Gündüz, Ertuğrul Çolak

Turkish Journal of Medical Sciences

Background/aim: Human leukocyte antigen (HLA) polymorphisms play a central role in immune recognition, disease susceptibility, and transplant success. The distribution of HLA alleles and haplotypes varies among ethnic and geographic populations. Despite several regional studies conducted in Türkiye, large-scale and comprehensive investigations comparing HLA profiles between healthy individuals and transplant candidates remain limited. The aim of this study was to compare the distribution of HLA profiles among donors, hematopoietic stem cell transplantation (HSCT) candidates, and solid organ transplant candidates.

Materials and methods: A total of 8472 individuals were included in the study, comprising 6422 donors and 2050 transplant candidates. HLA …

Pregnancy Outcomes In Systemic Sclerosis Before And After Diagnosis: A Retrospective Nationwide Cohort Study, Alper Doğanci, Serdar Can Güven, Nuray Yilmaz Çakmak, Rifat Bozkuş, Sali̇h Başer, Eki̇n Doğanci, Nesli̇han Öztürk, Şuayi̇p Bi̇ri̇nci̇, Nai̇m Ata

Turkish Journal of Medical Sciences

Background/aim: Pregnancy outcomes in women with systemic sclerosis (SSc) were evaluated in a nationwide cohort study. The impact of the disease on pregnancy outcomes was further assessed by comparing outcomes before and after the diagnosis of systemic sclerosis.

Materials and methods: A retrospective, nationwide, multicenter study was conducted under the supervision of the Ministry of Health. A nationwide cohort was between 1 January 2018, and 31 October 2025, including female patients with at least two recorded ICD codes for SSc (M34 subcategories) at an interval of at least 1 month, who were identified as pregnant before (pre-SSc) or after SSc …

Effects Of Repetitive Peripheral Magnetic Stimulation On Poststroke Ankle Spasticity: A Double-Blind Randomized Controlled Trial, Hüseyi̇n Oğuzhan Aslantaş, Şehi̇m Kutlay, Haydar Gök, Semra Özkan, Seçi̇lay Güneş, Ati̇lla Hali̇l Elhan

Turkish Journal of Medical Sciences

Background/aim: Repetitive peripheral magnetic stimulation (rPMS) is a noninvasive, painless therapy aimed at improving spasticity, with a proposed mechanism that involves neuromodulation through somatosensory and proprioceptive afferent stimulation. The present study evaluates the effectiveness of rPMS on ankle plantar flexor spasticity in participants with stroke.

Materials and methods: Included in this prospective, double-blind, randomized, sham-controlled study were 50 participants with poststroke ankle plantar flexor spasticity graded 1–3 according to Modified Ashworth Scale (MAS). Participants were randomized into rPMS (n = 25) and sham (n = 25) groups. All participated in a conventional rehabilitation program, while the rPMS group received 10 …

Skin Cancer Surgery Under Local Anesthesia: Clinicopathologic Characteristics And Age-Stratified Outcomes In 533 Patients, Menekşe Kastamoni̇ Başkan, Süleyman Çeçen, Selçuk Akin, Şaduman Balaban Adim, Güzi̇n Yeşi̇m Özgenel

Turkish Journal of Medical Sciences

Background/aim: Skin cancer is the most common malignancy worldwide, particularly among elderly individuals. Many lesions are detected at an early stage because of their visibility and can be excised under local anesthesia, thereby avoiding the risks associated with general anesthesia or sedation. This study aimed to evaluate patient- and tumor-related characteristics in skin cancer surgery performed under local anesthesia, with particular emphasis on age-related outcomes.

Materials and methods: This retrospective study included 533 patients with 613 histopathologically confirmed skin cancers excised under local anesthesia between 2019 and 2024. Demographic, histopathological, and surgical variables were recorded, including age, sex, tumor location, …

Long-Term Outcomes Of Lamellar Crescentic Wedge Resection On Corneal Astigmatism And Optical Aberrations In Patients With Advanced Pellucid Marginal Degeneration, Ayşe Burcu, Hande Hüsni̇ye Telek, Hakan Mert, Yaprak Arzu Özdemi̇r, Züleyha Yalniz Akkaya, Evi̇n Şi̇ngar, Selma Özbek Uzman

Turkish Journal of Medical Sciences

Background/aim: The present study investigates the long-term changes in corneal astigmatism and aberrations following lamellar wedge resection in cases with advanced pellucid marginal degeneration (PMD).

Materials and methods: Patients with advanced PMD whose visual acuity did not improve with glasses or contact lenses underwent lamellar crescentic wedge resection. Pre- and postoperative assessments at 3, 6, 12, and 24 months using Pentacam HR were conducted to identify changes in corrected visual acuity, corneal astigmatism, and higher-order aberrations (HOAs) following the procedure, and compared with a control group.

Results: Statistically significant postoperative improvements in corrected visual acuity were observed at 6 and …

Serum Angiopoietin-1 And Angiopoietin-2 Levels In Turkish Patients With Behçet’S Disease: Associations With Clinical Manifestations And Inflammatory Markers, Sercan Gücenmez, Hakan Emmungi̇l, Fi̇gen Yargucu Zi̇hni̇, Gökhan Keser, Kenan Aksu

Turkish Journal of Medical Sciences

Background/aim: Emerging evidence suggests that dysregulated angiogenesis may contribute to the pathogenesis of Behçet’s disease (BD). This study primarily aimed to investigate serum angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) levels in Turkish patients with BD and compare them with healthy controls. The secondary aims were to compare angiopoietin levels based on clinical manifestations, disease activity, and medication use and to investigate their correlations with age, disease duration, and inflammatory markers.

Materials and methods: This cross-sectional study included 56 consecutive patients with BD, diagnosed according to International Study Group criteria, and 56 age- and sex-matched healthy controls. Physical characteristics, clinical manifestations, time …

Comparison Of Ultrasound-Guided Serratus Posterior Superior Intercostal Plane Block And Thoracic Paravertebral Block For Postoperative Analgesia After Breast Surgery: A Prospective Randomized Noninferiority Trial, Mustafa Sirri Kotanoğlu, Musa Zengi̇n, Onur Küçük, Atakan Sezgi̇, İbrahi̇m Topcu, Aras Meti̇n, Zeynep Ersoy, Jüli̇de Ergi̇l

Turkish Journal of Medical Sciences

Background/aim: This noninferiority trial aimed to evaluate whether the serratus posterior superior intercostal plane block (SPSIPB) provides noninferior postoperative analgesia compared with the thoracic paravertebral block (TPVB) after unilateral mastectomy.

Materials and methods: This prospective, randomized, assessor-blinded, parallel-group noninferiority trial enrolled 60 female patients scheduled for elective unilateral mastectomy. Patients received either ultrasound-guided SPSIPB (n = 30) or TPVB (n = 30) with 30 mL of 0.25% bupivacaine before induction. The primary outcome was visual analogue scale (VAS) pain scores (0–100 mm) at rest and during coughing over 24 h. Noninferiority was assessed using the Hodges–Lehmann median difference with 95% …

Impact Of Transforaminal Epidural Steroid Injection On Pain, Disability, And Kinesiophobia In Lumbar Disc Herniation With Radicular Pain, Hande Ece Öz, Rumeysa Çeti̇nkaya Bulutoğlu, Furkan Çeti̇n, Ezgi̇ Can, Alp Eren Çelenli̇oğlu, Ender Si̇r

Turkish Journal of Medical Sciences

Background/aim: The aim was to evaluate the effect of single-level transforaminal epidural steroid injection (TFESI) on kinesiophobia (KP) in patients with lumbar radicular pain (RP) caused by single-root, single-level lumbar disc herniation (LDH).

Materials and methods: A total of 63 patients diagnosed with unilateral single-level radicular pain due to LDH and treated with single-level TFESI were included. The Numeric Rating Scale (NRS), modified Oswestry Disability Index (MODI), Tampa Scale of Kinesiophobia (TSK), and Neuropathic pain (NP)-Douleur Neuropathique 4 Questionnaire (DN4) were used before the procedure and at 3 weeks and 3 months postoperatively.

Results: At baseline, 76.19% (n = 48) …

Non-Pulmonary Arterial Involvement In Behçet's Disease: A Multicentre Retrospective Case Series, Özge Karakök, Duygu Keri̇m, Şeri̇fe Çoşkun-Sağirkaya, Gamze Akkuzu, Burcu Ceren Uludoğan, Gezmi̇ş Ki̇myon, Hasan Kocaayan, Senar Şan, Özkan Urak, Gökçe Kenar, Ayşe Cefle, Servet Akar, Nazi̇fe Şule Yaşar-Bi̇lge, Cemal Bes, Şükran Erten, Ahmet Omma, Gökhan Keser, Kenan Aksu, Tüli̇n Ergun, Rafi̇ Haner Di̇reskeneli̇, Fatma Ali̇baz-Öner

Turkish Journal of Medical Sciences

Background/aim: In Behçet’s disease (BD), arterial involvement represents a significant clinical challenge associated with serious complications. The present study evaluates the characteristic features, affected vessels, lesion types, treatments, and outcomes in BD patients with nonpulmonary arterial involvement.

Materials and methods: Included in this retrospective study were 65 BD patients whose interventions and clinical courses were accessed from medical records. The treatments administered included immunosuppressive (IS) therapies and surgical/endovascular procedures. Fisher’s exact and t-test/Mann–Whitney U test were used for statistical analysis.

Results: Fifty-nine of the patients (90.8%) were male. The median (Q1–Q3) follow-up was 4 (2–12.8) years. The most commonly affected …

Clinical Outcomes Of Injectable And Conventional Pulmonary Valve Replacement In Severe Pulmonary Regurgitation, Sercan Tak, Murat Koç, Ali̇ Kutsal, Vehbi̇ Doğan

Turkish Journal of Medical Sciences

Background/aim: Pulmonary regurgitation following tetralogy of Fallot repair is a common long-term complication requiring pulmonary valve replacement. Injectable bioprosthetic valves offer a less invasive alternative to conventional surgical replacement, but comparative data in pediatric populations remain limited. This study aimed to evaluate short-term and long-term clinical outcomes of injectable pulmonary valve replacement and conventional pulmonary valve replacement in pediatric patients with severe pulmonary regurgitation following tetralogy of Fallot repair.

Materials and methods: This retrospective study included 22 pediatric patients who underwent pulmonary valve replacement. Patients were divided into injectable (n = 9) and conventional (n = 13) groups based on …

Common Femoral Vein Wall Thickness As A Supportive Imaging Marker In The Differential Diagnosis Of Behçet’S Uveitis, Seda Kutluğ Ağaçkiran, Esra Kardeş, Abdulbaki̇ Ağaçkiran, Haner Di̇reskeneli̇, Fatma Ali̇baz-Öner

Turkish Journal of Medical Sciences

Background/aim: Ocular involvement is a major cause of morbidity in Behçet’s disease (BD), and its diagnosis may be challenging, particularly for patients with isolated ocular manifestations or incomplete fulfillment of diagnostic criteria. Increased common femoral vein (CFV) wall thickness measured by Doppler ultrasonography (US) has previously been shown to be a sensitive and specific marker for systemic BD. This study aimed to evaluate whether CFV wall thickness measurement may serve as a supportive tool in distinguishing Behçet’s uveitis (BU) from other forms of inflammatory uveitis.

Materials and methods: This retrospective study included 45 patients with BU fulfilling the International Study …

Impact Of Race-Based And Race-Free Ckd-Epi Equations On Estimated Glomerular Filtration Rate In A Multicenter Retrospective Cohort Of Autosomal Dominant Polycystic Kidney Disease, Özgür Akin Oto, Abdulmeci̇t Yildiz, İsmai̇l Koçyi̇ği̇t, Hali̇l Yazici, Sai̇de Eli̇f Güllülü Boz, Yi̇ği̇t Kurtuluş, Alparslan Demi̇ray, Müge Doksan, Vafa Suleymanova, Ece Ük, Alper Akin, Bahar Bastani, John C. Edwards, Krista Leigh Lentine, Yaşar Kerem Çalişkan

Turkish Journal of Medical Sciences

Background/aim: The 2021 revision of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, which eliminates race-based coefficients, may significantly influence disease staging and treatment in autosomal dominant polycystic kidney disease (ADPKD). This study was designed to evaluate the impact of the 2021 race-free CKD-EPI equation on estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) staging in a multi-ethnic ADPKD population.

Materials and methods: In this multicenter, retrospective cohort study, 597 ADPKD patients were evaluated, including 515 self-identified as Caucasian and 82 as African-American. eGFR values at baseline and final follow-up were calculated using both the 2009 and 2021 …

Reliability And Validity Of The Turkish Version Of The Barthel Index-Dyspnea In Patients With Pulmonary Hypertension, Pinar Merç, Rengi̇n Demi̇r, Meli̇h Zeren, Habi̇be Durdu, Ümi̇t Yaşar Si̇nan, Mehmet Serdar Küçükoğlu

Turkish Journal of Medical Sciences

Background/aim: The Barthel Index-dyspnea (BI-d) is a respiratory disease-specific tool developed on the basis of the Barthel Index (BI), which provides a simple and quick way to measure the degree of dyspnea in activities of daily living (ADL). Dyspnea is one of the most common symptoms of pulmonary hypertension (PH). The objective of this study was to explore the reliability and validity of the Turkish version of the BI-d in patients with PH.

Materials and methods: A total of 73 PH patients were included in the study. Criterion validity was explored using the modified Medical Research Council (mMRC) dyspnea scale, …

Urinary Dkk3 As A Predictor Of Ckd Stages In Reflux Nephropathy In Children, Ayşe Seda Pinarbaşi, Nesli̇han Günay, İnayet Güntürk, Di̇dem Barlak Keti̇, Si̇bel Yel, Sekure Rabi̇a Ulueren, Cevat Yazici, Muammer Hakan Poyrazoğlu, İsmai̇l Dursun

Turkish Journal of Medical Sciences

Background/aim: Reflux nephropathy is an important cause of chronic kidney disease (CKD) in children. The search for new biomarkers continues, as early intervention is important to slow the progression of CKD. Urinary Dickkopf-3 (uDKK3), a potential marker of tubulointerstitial fibrosis, has been studied in adults but not extensively in children with CKD. This study was conducted to determine the role of uDKK3 levels in predicting the CKD stage in children with reflux nephropathy.

Materials and methods: This cross-sectional study included 113 children with CKD stages 1–4 with reflux nephropathy and 28 healthy controls. uDKK3 concentrations were measured using enzyme-linked immunosorbent …

Association Of Vitamin D, Oxidative Stress Markers, And Hormonal Factors With Male Infertility: A Case-Control Study In Pakistan, Muhammad Tayyab Ihsan, Ayesha Ali Malick, Sher Khan, Sher Khan, Muhammad Tahir Khan, Haq Nawaz Khan, Rehana Rehman

Turkish Journal of Medical Sciences

Background/aim: Infertility impacts around 15% of couples worldwide, with male factors accounting for approximately 50% of cases. Despite this significant share, male infertility remains understudied, particularly in developing nations such as Pakistan. The present study explores the association between male infertility and seminal plasma concentrations of oxidative stress markers, inhibin B, and vitamin D, along with their relationship with sperm parameters.

Materials and methods: The dataset of the study consisted of seminal plasma levels from 30 fertile and 60 infertile males. Total antioxidant capacity (TAC), Vitamin D, malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), lipid peroxide (LPO), superoxide dismutase (SOD), and inhibin B …

A High Fib-4 Score May Be An Early Sign Of Severe Liver Damage In Patients With Primary Antibody Deficiencies, Haci Uğur Muşabak, Tuba Erdoğan, Emre Özbek, Dudu Merve Durak Anşi̇n, Zumrud Mehti̇

Turkish Journal of Medical Sciences

Background/aim: Liver damage is a significant complication that increases mortality and morbidity in primary immunodeficiencies (PIDs). Although biopsy is the gold standard, the fibrosis-4 (FIB-4) scoring system is a noninvasive method for diagnosing liver fibrosis. In this study, we investigated the value of the FIB-4 score as an early indicator of liver damage in patients with primary antibody deficiencies (PADs).

Materials and methods: Of 52 patients, 40 had common variable immunodeficiency (CVID), 12 had immunoglobulin G subclass deficiency (IgG-SGD), and they were enrolled in the study. Patients were divided into hematology, rheumatology + dermatology, gastroenterology/hepatology, and respiratory diseases groups based …

Optimistic And Ambivalent Attitudes Toward Clinical Artificial Intelligence, Sevi̇l Uygun İli̇khan, Si̇nem Ülke, Mahmut Özer, Matjaž Perc, Yavuz Ayhan

Turkish Journal of Medical Sciences

Background/aim: Artificial intelligence (AI) is increasingly being integrated into healthcare systems; however, healthcare professionals’ knowledge, attitudes, and perceptions regarding AI remain insufficiently understood. This study aimed to evaluate healthcare professionals’ perceptions of AI in clinical practice.

Materials and methods: This descriptive cross-sectional study included 260 healthcare professionals, including physicians, nurses, and healthcare technicians working at a tertiary public hospital in Türkiye. Participants completed the Healthcare Professionals and Artificial Intelligence Questionnaire, which assessed demographic characteristics, AI knowledge, workplace AI use, attitudes toward AI applications, ethical and legal concerns, perceived professional impact, and educational needs.

Results: Most participants reported limited AI knowledge; …