Experimental Biomedical Research (E-Journal)
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The impact of suprascapular nerve block on physiotherapy outcomes in chronic shoulder pain: A randomized controlled study
No full textAim: To investigate the addition of suprascapular nerve block (SSNB) to physiotherapy in the treatment of chronic shoulder pain.
Methods: 110 patients were included in the randomised, controlled, single-blind study. While patients in group 1 were subject to only physiotherapy, patients from group 2 were subject to SSNB additionally. All patients received 15 sessions of standard physiotherapy for 3 weeks. Patients were evaluated using visual analogue scale (VAS), Shoulder Pain and Disability Index (SPADI) and Nottingham Health Profile (NHP) three times before treatment (T1), at the end of treatment (T2) and at 3 months after the end of treatment (T3).
Results: Pain-VAS and SPADI scores: Significant differences were found between T1, T2, and T3 in both within-group and intergroup comparisons. NHP scores: Significant differences were found between T1, T2, and T3 for all parameters except fatigue at T2 (Group 1). Inter-group comparison showed significant differences across most parameters. Pain-VAS, SPADI, and NHP difference scores: statistically significant difference was found in all evaluation parameters of T2 and T3 compared to T1.
Conclusion: We found that SSBN may increase physiotherapy’s effectiveness in improving pain, functional status, and quality of life of patient
Comparison of transoral laser surgery and open partial surgery in early-stage laryngeal cancers
No full textAim: To compare demographic data between open partial laryngectomy (OPL) and transoral laser microsurgery (TLM) in early-stage laryngeal cancer.
Methods: A retrospective analysis was conducted on 55 patients treated for early-stage (T1–T2, N0, M0) glottic squamous cell carcinoma between 2015 and 2025. Thirty-one patients underwent TLM and 24 underwent OPL. Hospital stay duration, tracheostomy rates, and nasogastric tube placement rates were evaluated.
Results: Demographic and tumor stage distributions were comparable between groups. None of the patients in the TLM group required tracheostomy or nasogastric tube placement, whereas all patients in the OPL group did. The mean hospital stay was significantly shorter in the TLM group (3.16 ± 1.93 days) compared with the OPL group (21.21 ± 11.41 days; p < 0.001).
Conclusion: TLM provides superior demographic data compared to OPL in early-stage laryngeal cancer, with significantly reduced hospital stay, elimination of tracheostomy and nasogastric tube requirements, and faster functional recovery. These findings support TLM as the preferred surgical approach for early-stage glottic cancers
Investigation of the relationship between HbA1c and tumor markers in type 2 diabetes mellitus
No full textAim: Tumor markers are frequently measured in patients with type 2 diabetes mellitus (T2DM), yet their interpretation is challenging because hyperglycemia may influence marker levels. This study aimed to examine the relationship between hemoglobin A1c (HbA1c) and commonly used tumor markers in T2DM.
Methods: In this retrospective cross-sectional study, 557 T2DM patients were included. HbA1c and tumor markers—carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), prostate-specific antigen (PSA), carbohydrate antigen 19-9 (CA19-9), cancer antigen 15-3 (CA15-3), cancer antigen 72-4 (CA72-4), and cancer antigen 125 (CA125)—were measured concurrently. Patients were compared by HbA1c <7% vs ≥7%. Spearman correlations with 95% confidence intervals and Holm–Bonferroni-adjusted p values were calculated. Multivariable linear regression models for log-transformed markers were adjusted for age, sex, smoking, and estimated glomerular filtration rate.
Results: The cohort (33.4% female; mean age 68.3±12.7 years) had a median HbA1c of 6.96%. Median CEA and CA72-4 levels were slightly higher in the HbA1c ≥7% group. HbA1c showed a weak positive correlation with CEA, while correlations with CA19-9 and CA72-4 were very weak and lost significance after correction. In adjusted regression analyses, HbA1c was not an independent predictor of AFP, PSA, CA19-9, CA15-3, or CA125. Its association with CEA was borderline and explained little variance; CA72-4 results were unstable due to limited data.
Conclusions: In T2DM, HbA1c demonstrates only a weak association with CEA and no independent relationship with other tumor markers. Therefore, elevated tumor markers in T2DM should not be attributed solely to poor glycemic control, and appropriate diagnostic evaluation should be maintained
Transcriptional regulons of tumor-associated macrophages reveal divergent polarization states across cancer types
No full textAim: To investigate transcription factor regulons that drive macrophage polarization across multiple cancer types using single-cell RNA sequencing data.
Method: Publicly available datasets from lung, ovarian, pancreatic, and head and neck cancers were retrieved. After standard quality control and normalization, gene regulatory networks were reconstructed using our bioinformatic workflow, which integrates co-expression analysis, motif enrichment, and regulon activity scoring. Transcription factors associated with M1 and M2 macrophage polarization were systematically examined.
Results: Analysis of regulon activity revealed that macrophages in lung, ovarian, and pancreatic cancers predominantly exhibited M1-associated transcriptional programs, suggesting anti-tumor properties. Key active transcription factors in these cancers included JUND, STAT1, NFκB, and IRF1. In contrast, head and neck cancers displayed a predominance of M2-associated transcriptional activity, with strong enrichment of SPI1, CEBPB, and IRF8, indicative of pro-tumor macrophage polarization. These findings highlight cancer type–specific heterogeneity in macrophage transcriptional regulation.
Conclusions: This study demonstrates that transcription factor regulon analysis can distinguish tumor-associated macrophage states across cancers and provides insights into their divergent roles in tumor progression. The identification of cancer type–specific transcriptional drivers of macrophage polarization may inform the development of macrophage-targeted immunotherapies and improve prognostic biomarker discovery
Reduced efficacy of nivolumab following prior immunotherapy in metastatic renal cell carcinoma: Implications for sequential immune checkpoint inhibition
No full textAim: To evaluate the effect of first-line interferon therapy on survival outcomes in patients treated with nivolumab for renal cell carcinoma (RCC).
Methods: This retrospective study included 67 patients with mRCC who received nivolumab between March 2016 and September 2024 at our institution. Patients were stratified according to whether they had received interferon as first-line therapy. Survival outcomes following nivolumab were compared between the interferon and non-interferon groups.
Results: Among the 67 patients, 47 (70.1%) were male and 20 (29.9%) were female. At diagnosis, 36 patients (53.8%) had metastatic disease. Patients previously treated with interferon had a median progression-free survival (mPFS) of 6.7 months with nivolumab, compared with 13.7 months among those without prior interferon (p = 0.049). Similarly, the median overall survival (mOS) was 7.2 months in the interferon group versus 23.0 months in the non-interferon group (p = 0.003).
Conclusion: Prior interferon therapy appears to diminish the efficacy of subsequent nivolumab treatment in mRCC, suggesting potential limitations to sequential ICI strategies. These findings highlight the need for prospective studies to optimize the sequencing of immunotherapeutic agents in mRCC
Comparison of some baseline variables and radiation exposure between prospective and retrospective electrocardiography-coupled coronary CT angiography protocols: A single-center observational study
No full textAim: To compare the radiation doses received by patients undergoing coronary computed tomography (CT angiography) using prospective and retrospective electrocardiogram (ECG) simultaneous protocols, considering factors such as age, gender, body mass index, heart rate, and Agatston calcium score.Methods: A total of 80 patients (heart rate: 45–78 bpm) were retrospectively evaluated. Forty-two (42) patients underwent prospective ECG-gated scanning, and thirty-eight (38) underwent retrospective ECG-gated scanning. Patients' age, gender, body mass index (BMI), Agatston calcium score, dose-length product (DLP), and effective dose (mSv) were recorded. The effective radiation dose (mSv) was calculated by multiplying the DLP by a conversion coefficient of 0.014. The scanner utilized radiation dose-reduction technologies, including CARE kV algorithms, X-CARE (Organ-Based Dose Modulation), CARE Dose 4D and Tin Filter.
Results: The mean effective radiation doses were recorded as 1.54 mSv for the prospective cohort and 2.85 mSv for the retrospective cohort. While no statistically significant disparity was observed based on gender, a weak positive correlation was detected between patient age and radiation dose (r=0.09, p<0.05).Conclusion: Prospective ECG-triggered acquisition yields significantly lower radiation exposure than retrospective protocols, contingent upon rigorous patient selection and the maintenance of appropriate heart rate limits. Irrespective of the scanning technique employed, a positive correlation was established between effective radiation dose and both Body Mass Index (BMI) and heart rate, whereas no statistically significant association was found regarding age or gender. While the relationship between Agatston score and effective dose appeared more distinct within the retrospective cohort, it presented only a weak positive correlation that failed to reach statistical significance
Association between uric acid/high-density lipoprotein (HDL) cholesterol ratio and the presence of diabetic retinopathy
No full textAim: To evaluate the hypothesis that the uric acid–to–high-density lipoprotein cholesterol ratio (UHR) may serve as a potential biomarker for predicting diabetic retinopathy (DR) in patients with Type 2 diabetes mellitus (T2DM).
Methods: A total of 175 patient files were retrospectively analyzed between January 2023 and June 2024 at the Ophthalmology Clinic of Bolu Abant Izzet Baysal University. The study consisted of 100 diabetic patient files with diabetic retinopathy and 75 diabetic patient files without diabetic retinopathy. The parameters were recorded, and the calculated parameter was the Uric Acid/HDL Ratio (UHR).
Results: There were marked differences between the DR and control groups in a number of hematological and biochemical variables like Hemoglobin (HGB), High Density Lipoprotein Cholesterol (HDL-C), Lymphocyte Count (LYM), Red Blood Cell Distribution Width (RDW), Platelet Distribution Width (PDW), Alanine Transaminase (ALT), Serum Albumin, UHR. UHR correlated positively with RDW and C-reactive protein (CRP) and negatively with HGB, LYM and albumin. In ROC analysis, a UHR >0.1156 showed 86.1% sensitivity and 82.4% specificity in predicting DR. In the multivariate model, UHR was independently associated with diabetic retinopathy, retaining statistical significance (p < 0.001).
Conclusion: The association between UHR and chronic inflammatory parameters emphasizes the importance of inflammation in the pathogenesis of DR and supports its use as a suitable biomarker to determine the likelihood and severity of DR in T2DM patients. Longer-term research is needed to confirm the usefulness of UHR in clinical practice, which has the potential to supplement standard glycemic measurements
Optimal timing in staged bilateral total knee arthroplasty: A retrospective analysis of complications and functional outcomes
No full textAim: To investigate the association between inter-stage timing and postoperative complications, hospital readmissions, and functional outcomes in staged bilateral TKA.
Methods: A retrospective analysis was performed on 815 staged bilateral TKA cases between March 2019 and April 2024. Patients were stratified into four groups based on inter-stage intervals: 3 weeks–90 days, 91–180 days, 181 days–1 year, and >1 year. Demographic data, complication rates, unplanned readmissions, length of hospital stay, and functional outcomes, as Knee Osteoarthritis Outcomes Score for Joint Replacement (KOOS JR) and the Lower Extremity Activity Scale (LEAS), were analyzed.
Results: A total of 645 patients (1,290 knees) met inclusion criteria. The 91–180 days group demonstrated the lowest complication rate (1.8%), significantly lower than the 3 weeks–90 days group (13.1%; p<0.001). Functional outcomes were superior in the 91–180 days group, with higher KOOS JR (p=0.035) and LEAS scores (p=0.002). Although hospital stay and readmissions were lower in this group, differences in readmission rates were not statistically significant.
Conclusion: Early reoperation within 90 days carries a substantially elevated complication risk. Our data strongly suggest that scheduling the second TKA between 91 and 180 days offers the most favorable balance of safety and functional recovery. These findings address a critical gap in surgical planning for bilateral TKA and warrant further validation through prospective multicenter trials
Clinical comparison of hematuria degree and pathology according to the AUA bladder cancer risk classification
No full textAim: To determine the relationship between microhematuria level and bladder cancer diagnosis and staging.
Methods: A total of 452 patients who visited the Urology Clinic of the Faculty of Medicine of Afyonkarahisar Health Sciences University between 2017 and 2024 with complaints such as hematuria, dysuria, and suprapubic pain, and who underwent TUR-M surgery due to suspected bladder cancer-based on laboratory and imaging methods, were included. The pathology results confirmed the diagnosis of bladder cancer. In addition to demographic information such as age, gender, number of cigarettes smoked, and the presence of other risk factors for urothelial carcinoma (UC), data on hematuria levels, tumor stage and grade, American Urological Association (AUA) risk classification, microhematuria risk stratification, and pathological findings including lymphovascular invasion (LVI) and perineural invasion (PNI) were also recorded.
Results: Patients with more than 25 erythrocytes per microliter of urine or those with macroscopic hematuria had higher rates (42.1%) of additional risk factors for UC than other groups (p=0.040). The rate of high-stage and high-grade tumors was significantly higher in the group with >25 erythrocytes per microliter of urine compared to the other groups (p < 0.001, p < 0.001). When analyzing the AUA risk classification across the groups, 42 (32.8%) patients in the 3-10 erythrocyte group and 21 (35%) patients in the 10-25 erythrocyte group were classified as high risk. In contrast, 152 (64.7%) patients in the >25 erythrocyte group were classified as high risk, a rate significantly higher than in the other groups (p < 0.001).
Conclusions: Hematuria level is associated with tumor grade, tumor stage, and muscle invasion in bladder cancer. Given this association, it is crucial to carefully assess hematuria levels and the microhematuria risk classifications of patients
Evaluation of a central core MDR region as an optimum chromatin opening model
No full textAim: To examine whether the sub-regions of the HNRPA2B1 CBX3 UCOE (A2UCOE) preserved UCOE functionality. This inquiry was driven by several reports that challenge the requirement of associated promoter activity for UCOE functionality.
Method: The 0.9kb central A2UCOE region, thought to form a potential MDR (methylation determining region), was placed upstream of the SFFV-eGFP cassette. These constructs were subsequently analyzed alongside the 1.5A2UCOE and 2.2A2UCOE to assess their ability to inhibit transcriptional repression.
Results: In this study, we investigated whether sub-regions of the HNRPA2B1 CBX3 UCOE (A2UCOE) retained UCOE activity. Lentiviral vectors were used to evaluate the stability and efficiency of eGFP expression in P19 and F9 embryonal carcinoma cells. LB medium was prepared, and recombinant plasmids were transformed into competent E. coli DH5α cells. HEK293T cells were cultured for lentiviral production and transduction experiments were performed. eGFP expression was analyzed by flow cytometry before and after differentiation of P19 and F9 cells. Statistical analysis was performed using Prism, with p < 0.05 considered significant.
Conclusions: This study demonstrates that the 0.9 kb core region of A2UCOE, containing the promoters of HNRPA2B1 and CBX3, exhibits partial resistance to transgene silencing in both undifferentiated and differentiated P19 and F9 cells. The findings indicate that the size of the CpG-rich region is critical for maintaining open chromatin structure and ensuring full UCOE functionality. Our study highlights the potential of smaller A2UCOE subregions for gene therapy; however, further optimization is required to achieve full activity independent of promoter influence