Background: Cinematic rendering (CR) is an advanced post-processing technique that generates volumetric 3-dimensional (3D) visualizations from routine clinical magnetic resonance imaging (MRI) data, potentially enhancing anatomical interpretation and spatial understanding. Methods: In this retrospective single-center study, 3.0-T MRI datasets from 35 participants (15 healthy controls and 20 patients with histopathologically confirmed primary brain tumors) were analyzed. Cinematic rendering images were generated from precontrast 3D T1-weighted magnetization-prepared rapid acquisition gradient echo (MPRAGE) sequences. Two independent senior observers evaluated image resolution, anatomical detail, lesion depiction, visualization utility, and educational value using a 3-point Likert-type scale. Interobserver agreement was assessed using quadratic weighted Cohen’s κ with bootstrap-derived 95% confidence intervals. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 29.0 (IBM Corp.; Armonk, NY, USA). Results: Cinematic rendering provided consistent, high-fidelity 3D visualization of normal neuroanatomy and tumor-related structural alterations across different primary brain tumor histologies. Image quality ratings were uniformly high (median score: 3), with no significant differences between groups (P ≥ .229). Educational value was rated consistently by both observers across all cases. Interobserver agreement ranged from substantial to almost perfect (κ = 0.65-1.00), with perfect agreement for lesion depiction (κ = 1.00; 100% agreement). Conclusion: Cinematic rendering applied to routine brain MRI provides reproducible, depth-enhanced 3D visualization of normal brain anatomy and tumor-related spatial relationships. The technique demonstrates consistent image quality and interpretability across different tumor types and may serve as a supplementary tool for neuroanatomical education and spatial understanding in clinical practice. Cite this article as: Fırat Z, Er F, Ieva AD, Ekinci G, Türe U. Cinematic rendering of brain magnetic resonance imaging: photorealistic visualization of normal neuroanatomy and primary brain tumors. Eurasian J Med. 2026, 58(4), 1605, doi: 10.5152/ eurasianjmed.2026.261605.
Background: In this study, breast magnetic resonance imaging (MRI) examinations were retrospectively reviewed. This study evaluated whether the indications for breast MRI were consistent with the recommendations of the Breast Imaging Reporting and Data System (BI-RADS)atlas. Additionally, the study assessed whether prior ultrasound and mammography findings were sufficient for diagnosis. The aim was to identify potentially unnecessary breast MRI examinations and their associated financial burden. Methods: Breast MRI reports were compared with previous mammography and ultrasound reports. Patients for whom breast MRI provided no additional diagnostic benefit were identified, and the indications for MRI examination were analyzed. Results: Comparison of BI-RADS categories assigned on prior ultrasound and mammography with those assigned after breast MRI revealed that 321 (64.3%) of the 499 patients could have been adequately managed without breast MRI. In these patients, MRI findings did not alter clinical management or treatment decisions. Conclusion: Breast MRI is a costly imaging modality with limited accessibility in many healthcare settings. Therefore, its economic impact should be carefully considered when determining appropriate indications for its use. These findings suggest that the absence of restrictive criteria for breast MRI requests may contribute to substantial financial losses due to unnecessary examinations. Cite this article as: Şenbil DC, Kılıçparlar MB, Kantarcı M, Aydın S. Assessment of potentially unnecessary breast magnetic resonance imaging utilization and its economic impact: A retrospective study. Eurasian J Med. 2026, 58(4), 1562, doi: 10.5152/eurasianjmed.2026.261562.
Background: Immunopathological dysregulation has been implicated as a unifying substrate for both atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), 2 conditions that cluster with disproportionate frequency in clinical cardiology practice. Systemic immune-inflammation index (SII)—a hematological index derived from the ratio of platelet–neutrophil product to lymphocyte count—has garnered increasing attention as a low-burden inflammatory surrogate. The capacity to discriminate AF from sinus rhythm was investigated in an outpatient cohort with HFpEF. Methods: A retrospective analysis was conducted on 207 HFpEF outpatients (January 2024-January 2025) stratified by resting electrocardiogram rhythm: sinus rhythm (group 1, n = 105) vs. AF (group 2, n = 102). Independent AF predictors were identified through multivariate binary logistic regression. Results: Four variables independently predicted AF on multivariate analysis: SII (P = .04), age (P = .010), left atrial diameter (P < .001), and systolic pulmonary artery pressure (P < .001). At an optimal SII threshold of 584.64, sensitivity reached 79.4% and specificity 59% for AF prediction (AUC = 0.727, 95% CI = 0.658-0.796, P < .001). Conclusion: Systemic immune-inflammation index constitutes a cost-neutral, universally derivable hematological parameter with meaningful clinical utility for AF risk stratification within the HFpEF phenotype. Patients harboring pronounced SII elevation warrant heightened arrhythmia vigilance through serial 12-lead recordings and extended ambulatory electrocardiographic monitoring—should be considered in HFpEF patients with markedly elevated SII to facilitate timely AF detection. Cite this article as: Şentürk B, Kış M, Çöllüoğlu T, et al. The relationship between the systemic immune inflammatory index and atrial fibrillation in heart failure with preserved ejection fraction. Eurasian J Med. 2026, 58(4), 1589, doi: 10.5152/ eurasianjmed.2026.261589.
Background: Current guidelines recommend myeloperoxidase (MPO)- and proteinase 3 (PR3)-based immunoassays as the primary approach for antineutrophil cytoplasmic antibody (ANCA) testing, while indirect immunofluorescence (IIF) is reserved for selected clinical contexts. However, real-world data regarding concordance and workflow implications of these approaches remain limited. Methods: In this retrospective laboratory-based study, ANCA results from 8976 consecutive patients evaluated in a high-volume tertiary laboratory were analyzed. Indirect immunofluorescence patterns and MPO/ PR3 reactivity were assessed simultaneously using an integrated IIF-based platform. Concordance between IIF patterns and antigen-specific reactivity was evaluated, and retrospective workflow simulations were performed to estimate the effects of MPO/PR3-first and IIF-first testing approaches on laboratory test utilization. Results: Overall IIF positivity was observed in 589 patients (6.56%), whereas MPO and/or PR3 reactivity was detected in 307 patients (3.42%; 95% CI: 3.06-3.82%). Among IIF-positive patients, 438 (74.4%) showed no detectable MPO or PR3 reactivity, while 156 antigen-reactive patients (50.8%; 95% CI: 45.1-56.5%) showed no identifiable IIF reactivity. Retrospective workflow simulations suggested that an MPO/PR3-first approach would substantially reduce IIF testing volume, whereas an IIF-first strategy would markedly decrease antigenspecific testing volume. However, each approach was associated with distinct discordance patterns between IIF and MPO/PR3 reactivity within the study cohort. Conclusion: Substantial discordance was observed between IIF patterns and MPO/PR3 reactivity. The findings reflect laboratory concordance and workflow characteristics rather than true clinical diagnostic performance, and the clinical significance of discordant findings requires further evaluation in clinically characterized cohorts. Cite this article as: Arslan A, Togay A. Real-world concordance of indirect immunofluorescence and antigen-specific assays in antineutrophil cytoplasmic antibody testing: A retrospective high-volume laboratory study. Eurasian J Med. 2026, 58(4), 1498, doi: 10.5152/eurasianjmed.2026.261498.
Although bariatric surgery (BS) is a well-established and effective method for treating obesity, it carries the risk of developing psychiatric complications in the postoperative period. This narrative review is based on a literature search in PubMed, Scopus, and Google Scholar, covering studies published between January 2010 and September 2025. This review comprehensively examines various psychiatric conditions that may emerge following BS, including depression, anxiety, eating disorders, psychotic disorders, alcohol use disorders, and substance use disorders. The neurobiological and psychosocial mechanisms underlying these postoperative psychiatric symptoms are evaluated, and the effects of pharmacokinetic changes on psychiatric pharmacotherapy are discussed in this review. Additionally, special risk populations, psychiatric contraindications to surgery, and treatment and follow-up strategies are reviewed in light of the current literature. Multidisciplinary assessment and long-term psychiatric monitoring appear essential to optimize psychiatric outcomes and maintain the long-term success of BS. Cite this article as: Sun T. Psychiatric complications after bariatric surgery: A narrative review. Eurasian J Med. 2026, 58(4), 1238, doi: 10.5152/ eurasianjmed.2026.251238.
Antiphospholipid syndrome (APS) is characterized by persistent antiphospholipid antibodies (aPL) associated with thrombotic and/or obstetric complications. Malignancies are strongly prothrombotic, and growing evidence suggests clinically relevant interactions between aPL and cancer. Interpretation remains challenging because many oncologic studies rely on non-criteria aPL profiles, low titers, or single-time measurements that may not reflect clinically meaningful APS. The aim was to summarize current evidence regarding aPL in malignancy, focusing on prevalence, laboratory profiles, thrombotic manifestations, catastrophic antiphospholipid syndrome (CAPS), paraneoplastic associations, and potential clinical implications in oncology patients. A focused narrative review was conducted using PubMed/MEDLINE and PubMed Central (through October 26, 2025). Predefined search strategies emphasized antibody profile, persistence (≥12 weeks when available), tumor type, and thrombotic outcomes. Studies were selected for clinical relevance and verifiability, with structured synthesis of key findings. Meta-analytic data demonstrate increased anticardiolipin positivity in gastrointestinal, genitourinary, and lung cancers, whereas lupus anticoagulant and anti-β2GPI findings remain heterogeneous. Antiphospholipid antibodies positivity was frequently transient or low titer, limiting clinical interpretation. Persistent or high-risk aPL profiles were associated with increased thrombosis in selected subgroups. Catastrophic antiphospholipid syndrome and paraneoplastic APS have been reported in malignancy, and obstetric APS cohorts suggest a possible bidirectional relationship with cancer incidence. In conclusion, the malignancy–aPL interface involves increased antibody prevalence, phenotype-dependent thrombotic risk, CAPS association, and paraneoplastic mechanisms. Clinical interpretation must consider antibody profile and persistence, avoiding conclusions based on isolated positivity. Prospective studies are needed to clarify clinical relevance and guide screening strategies. Cite this article as: Carvalho JFd, Amadei LP, Rodrigues CEM. A dangerous partnership: malignancy and antiphospholipid antibodies. Eurasian J Med. 2026, 58(4), 1434, doi: 10.5152/ eurasianjmed.2026.261434.
Background: Chiari malformation type 1 (CM1) is a neurological disorder characterized by cerebellar tonsil herniation. While nuclear DNA has been associated with craniovertebral development, the role of mitochondrial DNA (mtDNA) remains unclear. This study investigated nuclear DNA variants (PAX1, EPAS1, DKK1, GDF6) and mtDNA D-loop mutations in CM1 patients from East Coast Malaysia. Methods: Sixty-eight participants were enrolled, comprising 38 CM1 patients and 30 controls. Genomic DNA from peripheral blood was analyzed by polymerase chain reaction amplification and Sanger sequencing. Associations between genetic variants and clinicopathological parameters (age, sex, tonsillar herniation, syringomyelia) were assessed using chi-square or Fisher’s exact test. Results: Four nuclear DNA variants were identified, comprising a synonymous PAX1 mutation (c.555G>A, p.K185K) and intronic changes in EPAS1 (c.1035-7C>G), DKK1 (c.548-3T>C), and GDF6 (c.406+112T>C), none of which exhibited significant associations with clinicopathological characteristics. In contrast, mtDNA analysis revealed that 50% of CM1 patients (n = 30) harbored D-loop mutations, predominantly T>C or G>A transitions, including 18 novel variants. Mutation frequency was significantly higher in patients with more severe tonsillar herniation (>10 mm) (OR = 28.570; 95% CI: 3.080-250.000; P < .001) and in those with syringomyelia (OR = 7.792; 95% CI: 1.782-34.060; P = .007), while no significant associations were observed with age or sex. Conclusion: Nuclear DNA variants may function as genetic modifiers without significant clinical impact. Conversely, mtDNA D-loop mutations were prevalent and correlated with disease severity, suggesting a contributory role in CM1 pathogenesis and warranting further investigation of mitochondrial genetic factors. Cite this article as: Rosdi SNM, Mohamed Yusoff AA. Nuclear and mitochondrial DNA variants in Chiari malformation type 1: insights from an east coast Malaysian cohort. Eurasian J Med. 2026, 58(4), 1209, doi: 10.5152/eurasianjmed.2026.251209.
Background: This study aimed to assess intergenerational differences in joint health and functional independence among adults with hemophilia and to examine the relationship between prophylaxis timing, dose intensity, and treatment adherence and long-term joint outcomes. Methods: A retrospective study was conducted including 91 adult patients with hemophilia A or B. Participants were classified into generational cohorts within different treatment eras. Joint health and functional status were assessed using the Hemophilia Joint Health Score (HJHS) and the Functional Independence Score in Hemophilia (FISH). Statistical analyses included correlation analyses, subgroup comparisons, and general linear models; subgroup analyses were considered exploratory. Results: The median age was 38 years, and prophylaxis was initiated at a median age of 27 years. Patients had a mean annual bleeding rate of 11.1, with a median of 2 joints affected per year, most commonly the ankles, knees, and elbows. The median prophylaxis dose was 20.8 IU/kg, and bleeding episodes significantly decreased in patients requiring dose escalation (P = .007). Higher joint scores were associated with poorer functional outcomes and a greater number of bleeding joints. Joint health and functional outcomes differed significantly across generations (P < .001), with worse outcomes in older cohorts. Follow-up showed no significant improvement over 1 year, although baseline and follow-up joint scores were strongly correlated (P < .001). Conclusion: In adults with hemophilia, delayed prophylaxis initiation was associated with poorer joint and functional outcomes. The observed intergenerational differences likely reflect historical variations in access to prophylaxis and treatment practices. Although individualized dose escalation improved bleeding control, established joint damage showed limited short-term reversibility. Cite this article as: Demirci Z, Soyer N, Keklik Karadağ F, Arslan A, Saydam G, Şahin F. Dose or timing? The role of prophylaxis in preventing joint bleeds in hemophilia: a cross-generational comparative analysis. Eurasian J Med. 2026, 58(4), 1208, doi: 10.5152/eurasianjmed.2026.251208.
Background: Artificial intelligence (AI) has increasingly been integrated into various fields of medicine, necessitating rigorous oversight by scientists to ensure its appropriate application. This study presents an analysis of microhemorrhages, which are closely associated with significant cerebrovascular events. Researchers have designed a study to investigate the feasibility of utilizing AI in the detection and assessment of microhemorrhages. Methods: The study retrospectively analyzed 108 patients with cerebral microhemorrhagic foci and 108 controls using cranial magnetic resonance imaging (MRI) and susceptibility-weighted sequences, following ethical approval. Deep learning models, including a customized DenseNet for classification and nnU-Net for segmentation, were trained on preprocessed MRI data to detect and localize microhemorrhages efficiently. Results: The study involved a total of 216 patients with and without cerebral microbleeds. There were a total of 146 foci in the 108 patient group. The classification model demonstrated an area under the curve of 80% ± 2.7% and an accuracy of 75% ± 1.7%, though specificity was more limited at 68% ± 4.3%. The segmentation model identified microhemorrhagic regions with a sensitivity of 89.4% ± 1.4% and achieved a Dice similarity coefficient of 62.05% ± 2.3%. Conclusion: Overall, both models demonstrated the potential for detecting and localizing microhemorrhages in 3D MRI data, though the classification model showed moderate specificity. The findings suggest that AI-based approaches may eventually serve as a supportive tool for microhemorrhage detection, provided further refinements are made to enhance detection accuracy and clinical applicability. Cite this article as: Akkaya HE, Polat Ö, Çolakoğlu H, Akpinar Dİ, Kaya E. Deep learning-based detection, classification, and segmentation of cerebral microbleeds. Eurasian J Med. 2026, 58(4), 1414, doi: 10.5152/eurasianjmed.2026.261414.
BACKGROUND:In this research, PD-1 and PD-L1 expression patterns were examined to determine their prevalence and prognostic relevance among patients with acute myeloid leukemia (AML). METHODS:Ninety-nine patients diagnosed with AML at the Hematology Department of Çukurova University Medical School between March 2009 and June 2017 were retrospectively analyzed. The expression levels of PD-1 and PD-L1 in bone marrow biopsy samples were determined using immunohistochemical methods. Their correlations with clinical and laboratory characteristics, treatment response, and survival data were analyzed. RESULTS:PD-1/PD-L1 positivity (≥ 5%) was observed in 9.1% of the cohort (n = 9). At the time of diagnosis, patients showing PD-1/PD-L1 expression exhibited significantly lower hemoglobin levels than those without expression (7.25 g/dL vs 8.80 g/dL; P = .017). Elevated PD-1/PD-L1 expression correlated with poorer overall survival, with a median OS of 11 months (95% CI: 5.9-16.1) compared to 24 months (95% CI: 13.4-34.6) in the non-expressing group (P = .033). CONCLUSION:Although PD-1/PD-L1 expression was relatively infrequent among AML patients, positive cases had significantly poorer survival. These findings suggest that PD-1/PD-L1 expression may be associated with poorer clinical outcomes in AML; however, larger studies are needed to clarify its prognostic relevance. Cite this article as: Varkal G, Gürkan E, Bağır EK, Mete B. PD1/PDL1 expression could be a prognostic factor in patients with acute myeloid leukemia. Eurasian J Med. 2026, 58(4), 1217, doi: 10.5152/ eurasianjmed.2026.251 217.
BACKGROUND:The relationship between serum copeptin (CPT) levels and the stage of hemorrhagic shock and the need for fluid/blood replacement in patients with gastrointestinal system (GIS) bleeding has not yet been clearly established. Therefore, this study was planned to evaluate the relationship between serum CPT levels and the stage of hemorrhagic shock and the need for fluid/blood replacement in patients diagnosed with GIS bleeding. METHODS:This prospective, single-center, observational study was conducted on a total of 90 patients; 43 of these were patients with GIS bleeding, and 47 were in the control group (peptic ulcer). Serum CPT levels were measured using the enzyme-linked immunosorbent assay method. Stages of hemorrhagic shock were determined according to the Advanced Trauma Life Support 11th edition. Hemoglobin, hematocrit, meancorpuscular volume, international normalized ratio, lactate, base deficit, and replacement needs were determined and recorded. RESULTS:While there was a statistically significant difference between serum CPT levels and the blood parameters studied in patients with GIS bleeding, only the stages of hemorrhagic shock did not statistically affect CPT levels. Increased fluid and blood product replacement was observed in advanced shock stages. CONCLUSION:Elevated serum CPT levels in patients with GIS bleeding may be a prognostic biomarker reflecting the severity of the disease. However, it is not sufficient on its own for determining hemorrhagic shock stages and predicting replacement needs. Cite this article as: Çalbay A, Çalbay MM, Akgöl Gür ST, Bayramoğlu A, Öztürk N, Albayrak B. Evaluation of the correlation of serum copeptin levels patients diagnosed with Gastrointestinal System bleeding with the stage of hemorrhagic shock. Eurasian J Med. 2026, 58(4), 1248, doi: 10.5152/ eurasianjmed.2026.251248.
Advanced kidney disease and renal replacement therapy are associated with numerous metabolic and nutritional imbalances. Nutrition plays a major role in reducing complications and improving quality of life. The aim of this structured narrative review was to explore the specific nutritional and fluid management challenges among hemodialysis patients in Albania. A search of various databases (PubMed, Cochrane Library, Medscape, UpToDate, and Google Scholar) was conducted for publications from 2000 to 2025, identifying 49 studies for inclusion. Evidence from the literature indicates that patients undergoing hemodialysis present with multiple vitamin and mineral deficiencies. Common issues include vitamin C, vitamin D, B6, B12, carnitine deficiency, and malnutrition prevalence of 43%-61% across various studies. In Albania, care is constrained by low household incomes; traditional diets high in phosphorus, potassium, and salt; the absence of renal dietitians; inconsistent patient and family education; and excessive interdialytic weight gain. Recommendations emphasize the need to implement routine measurements of biochemical markers such as serum prealbumin, anthropometric measurements such as body mass index and mid-upper arm circumference, evaluation of dietary intake at least every 3 months and objective monitoring tools such as bioimpedance spectroscopy for assessing extracellular volume status. The lack of official data on the nutritional status of hemodialysis patients in Albania highlights the urgent need for multicenter, collaborative research, and the establishment of improved, evidence-based nutritional regimens. Implementing these clinical and policy measures is crucial for significantly enhancing patient outcomes and enabling dialysis care in Albania to approach global standards. Cite this article as: Pina P, Prifti E, Nasto F, Shella M, Shtӫmbari X, Kaca S. Nutritional challenges in hemodialysis: a perspective from Albania. Eurasian J Med. 2026;58(4):1196, doi: 10.5152/ eurasianjmed.2026.251196.
Background: Attention-deficit/hyperactivity disorder (ADHD) and borderline intellectual functioning (BIF) are developmental conditions frequently characterized by executive dysfunction. However, the cognitive and neurophysiological differences between these conditions remain insufficiently defined. This study aimed to examine the behavioral and electrophysiological features of executive function in children with ADHD and BIF. Methods: Children with ADHD and BIF, along with typically developing controls, completed computerized Stroop and Go/No-Go tasks while electroencephalography was recorded. Behavioral performance was evaluated using reaction times, accuracy indices, omission errors, and commission errors. Electrophysiological analyses focused on P300 event-related potential amplitude and latency at frontal (F3, F4) and central (C3) electrode sites. Results: Children with BIF demonstrated slower reaction times, increased omission errors, and prolonged P300 latency at the F4 electrode, indicating reduced processing speed and attentional inefficiency. In contrast, children with ADHD exhibited faster but more error-prone response patterns, characterized by increased commission errors and shorter P300 latency, consistent with impulsivity and impaired inhibitory control. Conclusion: Attention-deficit/hyperactivity disorder and BIF share executive dysfunction but differ in underlying cognitive and neurophysiological profiles. Attention-deficit/hyperactivity disorder is primarily associated with disinhibition, whereas BIF is characterized by reduced processing speed and impaired sustained attention. Differences in P300 patterns may help distinguish between these conditions and support diagnosis and individualized intervention strategies. Cite this article as: Abanoz E, Korkmaz OE, Duru AD, Esin İS. Differential P300 signatures of executive dysfunction in attention-deficit/hyperactivity disorder and borderline intellectual functioning. Eurasian J Med. 2026, 58(4), 1539, doi: 10.5152/ eurasianjmed.2026.261539.
Background: Sudden sensorineural hearing loss (SSNHL) is an otologic emergency with a highly variable clinical course. Hyperbaric oxygen therapy (HBOT) has been widely used as an adjunctive treatment; however, its efficacy and determinants of treatment response remain incompletely defined. The aim of this study was to evaluate hearing outcomes in patients receiving HBOT and to assess the association between treatmentrelated factors and audiometric recovery. Methods: This retrospective study included 65 patients with idiopathic SSNHL. Pure tone audiometry thresholds were evaluated at baseline, post-treatment, and long-term follow-up when available. Changes were analyzed with the Wilcoxon signed-rank and Friedman tests, and correlations with recovery were assessed using Spearman’s analysis. Results: Complete pre- and post-treatment data were available for 65 patients. A statistically significant improvement in hearing thresholds was observed, decreasing from 41.7 ± 21.9 dB at baseline to 31.9 ± 22.1 dB following HBOT (P < .001). Among 19 patients with long-term follow-up, hearing thresholds further improved to 25.9 ± 17.3 dB. A significant difference was observed between baseline and long-term measurements (P = 0.006), although the overall comparison did not reach statistical significance (P = .209). No significant correlations were identified between hearing improvement and the number of HBOT sessions (r = 0.11, P = .387) or treatment delay (r = −0.06, P = .658). Etiological factors observed in the study population included upper respiratory infection (n = 30), acoustic barotrauma (n = 2), trauma (n = 1), and cases with no identifiable cause (n = 32). When analyzed according to etiology, no statistically significant difference in hearing threshold improvement was observed between groups (Kruskal–Wallis test, P = .151). Conclusion: HBOT demonstrated a positive effect on hearing thresholds in patients with SSNHL, with the observed audiological improvements appearing to be sustained at long-term follow-up Cite this article as: Kuduban O, Özkan R. Shortand long-term hearing outcomes after hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss. 2026, 58(4), 1486, doi: 10.5152/ eurasianjmed.2026.261486.
Background: This study aimed to investigate cerebellar volumetric and cortical-thickness differences in adults with autism spectrum disorder (ASD) using automated segmentation techniques, with a particular focus on sex-based anatomical patterns. Methods: A total of 100 participants from the Autism Brain Imaging Data Exchange database were included, comprising 48 adults with ASD (20 females, 28 males) and 52 healthy controls (23 females, 29 males). T1-weighted structural magnetic resonance imaging scans were processed using the CERES (CEREbellum Segmentation) module of volBrain to obtain lobule-specific cerebellar volume and thickness measures. Group comparisons were performed separately for males and females using non-parametric statistical tests. Results: Adults with ASD exhibited global cerebellar volumetric enlargement alongside lobule-specific reductions and altered pseudo-cortical thickness (PCT) across multiple lobules, most prominently within anterior sensorimotor and posterior cognitive regions. Several lobules demonstrated reversed asymmetry patterns relative to controls. Sex-stratified analyses suggested differential morphometric patterns between females and males with ASD; however, these findings should be interpreted as exploratory given subgroup sample sizes. Conclusion: These findings demonstrate distinct cerebellar morphometric alterations in adults with ASD and support the utility of automated cerebellar segmentation for region-specific anatomical characterization. The results indicate group-level neuroanatomical differences involving the cerebellum, while emphasizing cautious interpretation regarding clinical or group-level distinguishing feature implications. Cite this article as: Karakaş AB, Akbulut Y. Neuroanatomical cerebellar patterns in autism spectrum disorder. Eurasian J Med. 2026, 58(4), 1008, doi: 10.5152/eurasianjmed.2026.251008.
Background: The developing pediatric brain is vulnerable to nitrosative stress. This study investigated serum nitric oxide (NO), inducible nitric oxide synthase (iNOS), and S-nitrosothiols (SNOs) as peripheral biomarkers in children with anxiety disorders (ADs) and their associations with symptom severity. Methods: Eighty-one participants aged 7-17 years were enrolled, including 40 drug-naive participants with ADs and 41 age- and sex-matched healthy controls (HCs). Diagnoses were established using the Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime Version, DSM-5— Turkish version (K-SADS-PL-DSM-5-T). Symptom severity was assessed using the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Clinical Global Impression–Severity (CGI-S) Scale. Data were analyzed using between-group comparisons, correlation analyses, covariance analyses (MANCOVA/ ANCOVA), controlling for age, sex, and body mass index (BMI), and receiver operating characteristic (ROC) analysis. Results: Serum NO levels were significantly higher in the AD group compared with HCs (P = .028), whereas iNOS and SNO levels did not differ (P > .05). In adjusted analyses controlling for age, sex, and BMI, NO remained significantly higher, and iNOS and SNO levels were also significantly higher in the AD group. No marker (NO, iNOS, SNOs) correlated significantly with anxiety severity (all P > .05). Receiver operating characteristic analysis indicated modest diagnostic accuracy for NO (area under the curve (AUC) = 0.629, 95% CI: 0.506-0.752, P = .046), while iNOS and SNOs were not significant. Conclusion: Elevated NO, alongside adjusted increases in iNOS and SNO, supports altered peripheral nitrosative signaling in pediatric ADs. Nitric oxide showed modest discriminative value. Cite this article as: Okuyucu M, Ceylan MF, Hesapçıoğlu ST, Kafalı S, Neşelioğlu S, Erel Ö. Peripheral nitrosative stress in pediatric anxiety disorders: elevated serum nitric oxide levels. Eurasian J Med. 2026, 58(4), 1235, doi:10.5152/eurasianjmed.2026.251235.
Background: Breast cancer in very elderly women presents unique clinical and imaging characteristics, and data regarding this age group remain limited. This study aimed to evaluate the imaging characteristics of breast cancer in patients aged 80 years and older together with clinical and pathological findings. Methods: A retrospective analysis was performed on 23 patients aged 80 years and older diagnosed with breast cancer at a single institution between January 2021 and January 2026. Clinical presentation, tumor size, histological grade, metastasis status, and imaging findings, including mammographic features and Breast Imaging Reporting and Data System (BI-RADS) categories, were evaluated. Associations between clinical presentation and tumor characteristics were statistically analyzed. Results: Of the patients, 30.4% were diagnosed during screening and 69.6% following diagnostic presentation. Tumor size was significantly larger in the diagnostic group than in the screening group (median: 24.5 mm vs. 14.5 mm; P < .001). Distant metastasis occurred only in diagnostically presenting patients (31.3%), while lymph node metastasis rates were similar between groups (P > .05). Grade 2 tumors were the most common (39.1%). The most frequent mammographic findings were masses with or without calcifications, most commonly irregular in shape, with spiculated margins and high density. BI-RADS 5 was the most frequent category (60.9%). Conclusion: Breast cancer imaging features in women aged 80 years and older resemble those of the general population. Smaller tumor sizes and absence of distant metastasis in screen-detected cases suggest that screening may still support earlier detection in selected very elderly women. Cite this article as: Seyfettin A, Gültekin S, Kantarcı M. Imaging characteristics of breast cancer in women aged 80 years and older: A single-center experience. Eurasian J Med. 2026, 58(4), 1379, doi: 10.5152/ eurasianjmed.2026.261379.
Background: Schizophrenia (SZ) is a chronic neuropsychiatric disorder with marked impairments in cognitive, behavioral, and emotional functions. Despite extensive research, reliable molecular biomarkers of the disease have not yet been identified. Long non-coding RNAs (lncRNAs) stand out as regulatory molecules with diagnostic potential in many neurological and psychiatric disorders. This study aimed to evaluate the serum levels of HOXA transcript at the distal tip (HOTTIP), colon cancer–associated transcript 1 (CCAT1), and CCAT2 lncRNAs as potential biomarkers in SZ. Methods: Seventy antipsychotic-naive patients with SZ and 55 healthy controls participated in the study from June 2023 to May 2024. Control and SZ serum samples were collected, and the relative expression levels of HOTTIP, CCAT1, and CCAT2 were analyzed using reverse transcription-quantitative polymerase chain reaction. Results: Results showed that HOTTIP expression was significantly increased in patients with SZ (P < .05). However, no significant difference was observed in CCAT1 and CCAT2 levels between the groups. The association between increased HOTTIP levels and clinical symptom profiles suggests that this molecule may be linked to disease activity and SZ response. The HOTTIP showed modest discriminative ability (AUC = 0.60, 95% CI 0.50-0.70). Conclusion: The study was powered to detect moderate group differences; the null results for CCAT1/ CCAT2 therefore exclude moderate-or-larger effects but not small effects. HOTTIP may represent a noninvasive biological marker associated with SZ, although its standalone diagnostic utility appears limited. Cite this article as: Güzel Tanoğlu E, Çevik FE, Çakmur KN, Esen MF, Uzun FR, Erkıran M. Evaluation of serum long non-coding RNAs HOXA transcript at the distal tip, colon cancer–associated transcript 1, and colon cancer–associated transcript 2 as potential biomarkers in schizophrenia. Eurasian J Med. 2026, 58(4), 1271, doi: 10.5152/ eurasianjmed.2026.251271
