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The effect of one-year online counseling provided to mothers of children and adolescents with newly diagnosed type 1 diabetes on A1C and patient outcomes: A retrospective study
No full textCOMPARATİVE ANALYSİS OF TRİCHOSCOPİC FEATURES İN WOMEN WİTH ANDROGENETİC ALOPECİA AND TELOGEN EFFLUVİUM
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CD48 as a Novel Early Biomarker Complementing Procalcitonin and Lactate for Predicting Bacteremia in Pediatric Febrile Neutropenia: A Prospective Cohort Study
No full textBackground: Febrile neutropenia (FN) remains a frequent and potentially life-threatening complication in pediatric oncology, where prompt recognition of bacteremia is critical for risk-adapted therapy and antimicrobial stewardship. Traditional biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT) are widely used, yet their early predictive value is inconsistent across studies. Cellular activation markers measured by flow cytometry, particularly CD48, have been scarcely investigated in this setting. This study aimed to evaluate conventional, metabolic, and immune biomarkers for predicting bacteremia in children with FN and to assess the incremental diagnostic value of CD48. Methods: This prospective single-center cohort enrolled 38 pediatric oncology patients presenting with 46 FN episodes over 9 months. Clinical data, blood cultures, and serial measurements of CRP, PCT, lactate, interleukin-6, interleukin-8, MCP-1, sTREM-1, CD48, and CD64 were obtained at 0, 24, 48, and 72 hours. Bacteremia was defined by positive culture for a recognized pathogen. Receiver operating characteristic (ROC) analyses were performed to determine the area under the curve (AUC), sensitivity, and specificity. A multivariable logistic regression model evaluated the combined performance of biomarkers. Results: Bacteremia occurred in 12 (26.1%) FN episodes. Sepsis, tachycardia, and elevated lactate were more common among bacteremic patients. CRP showed limited early discrimination (AUC 0.62 on day 2) but improved by day 4 (AUC 0.74). PCT was consistently higher in bacteremia (AUC 0.89 at day 4), and lactate demonstrated strong early predictive value (AUC 0.81). CD48 was significantly elevated from 0–24 h (AUC 0.78), outperforming CD64 (AUC 0.60) and preceding the rise in CRP. In combined modeling, PCT + CD48 + lactate achieved the highest discrimination (AUC 0.92; sensitivity 92%, specificity 85%). Post-hoc power analysis showed 82% power to detect AUC differences ≥0.15. Conclusion: Integration of CD4 with PCT and Lactate markedly improved diagnostic accuracy in this cohort; however, given the limited number of bacteremic episodes, these findings should be considered exploratory and require external validation in larger, multicenter studies before clinical implementation
Diagnostic Performance of 3D Deep Learning, Radiomics, and Machine Learning for Non-Mass Enhancement in Breast MRI
No full textThe Effect of Smoking Cigarettes on the Progression of Psychotic Experiences to Psychotic Disorder: Evidence From a 6-Year Follow-Up Study.
No full textDyggve-Melchior-Clausen syndrome in three siblings: a unique case series with dual diagnosis of Down syndrome and Hirschsprung disease.
No full textMitochondrial Signaling and Regulation
No full textMitochondria are ubiquitous organelles that control adenosine triphosphate production, host metabolic pathways, and determine cell fate. Its initial recognized feature is being an energy source, but additional functions have been found over time. It supplies the energy requirements of all cells through oxidative phosphorylation. Additionally, it contributes to cell death apart from these roles. Cell death has been morphologically defined in three types: apoptosis, autophagic cell death, and necrosis. Apoptosis is characterized by a decrease in cell volume, reduced size of the nucleus (pyknosis), and fragmentation (karyorrhexis). Autophagic cell death takes place when the cell forms many vesicles without affecting the nucleus, ultimately leading to its digestion. Necrosis is identified by cell enlargement and the breaking of the plasma membrane, along with the absence of chromatin condensation and disruption of organelle structure.</p
Microplastic Pollution and Risk Evaluation in the Gediz River
No full textMicroplastics (MPs), particles less than 5 mm in diameter, enter the aquatic ecosystem through the degradation of larger plastics. They can accumulate in the environment for long periods due to their durability and buoyancy. In this study, a risk assessment of MPs was conducted at five different stations in the Gediz River via a Pollution Load Index (PLI) and a Polymer Hazard Index (PHI) calculated for dry and wet seasons to highlight the risks caused by seasonal variations of pollution levels for different types of MPs in an urban river discharging to Izmir Bay. The results showed that MPs were widespread in the area, with an average abundance of 13-211 units/L/L. During the dry season, the mean number of particles was 67 +/- 57; during the wet season, the mean number of particles decreased to 50 +/- 37. The most common type was polypropylene with 62.4%, followed by Polyethylene and Polyethylene Terephthalate (8.3% and 7.01%). The most abundant MP shapes are fragments and fibers, with 47.1% and 38.5%. During the dry season, PLI values ranged from 0.99 to 2.44, while in the wet period, they ranged from 1.08 to 2.11. Furthermore, PHI values for the MP species detected at each station ranged from 3.81 to 7.91. The results indicated that the Gediz River is a significant MPs source for Izmir Bay and demonstrates a major hazard for its overall ecological condition
Efficacy and safety of BRAF-MEK dual inhibition in BRAF-V600E mutated papillary craniopharyngioma: a systematic review
No full textPurpose: Papillary craniopharyngioma (PCP) is a rare central nervous system tumor with high recurrence and significant morbidity. The BRAF V600E mutation has emerged as a potential target for treatment, with BRAF-MEK inhibitors showing promise in early studies. However, their efficacy and safety remain uncertain due to limited data from small-scale studies and case reports. This systematic review aims to evaluate the clinical outcomes of dual BRAF-MEK inhibitor therapy in BRAF V600E-mutated PCP. Methods: A systematic search of OVID Medline, Embase, Scopus, PubMed, and Web of Science was performed following PRISMA guidelines. Studies reporting clinical outcomes of BRAF–MEK inhibitors in PCP were included. Due to the predominance of case reports, a narrative systematic review was performed without meta-analysis. Results: Twenty-one studies involving 54 patients met inclusion criteria. Treatment was administered as neoadjuvant (n = 11), adjuvant (n = 34), or palliative (n = 9) settings. Most reports were case-based; two cohort studies (Brastianos et al., n = 16; De Alcubierre et al., n = 14) reported volumetric response rates of 93.8% and 92.9%, respectively. Common presenting symptoms included hypopituitarism (60.5%), visual changes (47.3%), and headache (44.7%). Median therapy duration was 5 months (range, 1.5–31); 6 months (3–16) for neoadjuvant, 4.5 months (1.5–21) for adjuvant and 7 months (2–31) for palliative use. Median tumor volume reduction was 89% overall (neoadjuvant 90%, adjuvant 85%, palliative 88%). Reported toxicities were generally manageable. Conclusion: Dual BRAF-MEK inhibition demonstrates robust tumor responses and a favorable safety profile across neoadjuvant, adjuvant, and palliative settings in PCP. These preliminary findings support further investigation to define long-term efficacy, safety, and integration into clinical protocols