ISSN : 2146-3123
E-ISSN : 2146-3131

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In a study from Denmark, total 2224 overweight individuals (1504 women, 720 men) followed a low-calorie diet (810 kcal/daily) for 8 weeks. The low-calorie diet induced different effects in women than in men, suggesting gender‐specific changes after weight loss. Body weight loss and reductions in a metabolic syndrome score, fat mass, and heart rate were more marked in men compared to women. However, reductions in HDL-cholesterol, hip circumference, lean body mass (or fat free mass), and pulse pressure were larger in women than in men. Source:  https://onlinelibrary.wiley.com/doi/abs/10.1111/dom.13466
Louisa Gibson and Melanie Porter from Australiaaimed to investigate whether drinking or smoking while breastfeeding lowers children’s cognitive scores. They analyzed the data obtained from 5107 Australian infants recruited in 2004 and assessed every 2 years. The authors observed that exposing infants to alcohol through breastmilk may cause dose-dependent reductions in their cognitive abilities. The reduction in cognitive abilities was observed at age 6 to 7 years but was not sustained at age 10 to 11 years. The authors stated that although the relationship is small, it may be clinically significant when mothers consume alcohol regularly or binge drink.  Source: http://pediatrics.aappublications.org/content/142/2/e20174266
According to a meta-analysis performed by Clarke MA et al. 9% of women with postmenopausal bleeding have endometrial cancer. The authors analyzed data from 40790 unique patients in 129 studies published January 1, 1977, through January 31, 2017. They found that 90% of women with endometrial cancerhave postmenopausal bleeding; however, only 9% of women with postmenopausal bleeding were diagnosed with endometrial cancer.  Source: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2695509
In the Norwegian Mother and Child Cohort Study included a total of 50, 943 mothers recruited from 2002 to 2008 and their children, it was found that pregnant women with average (50–199 mg/day, 44%), high (≥200–299 mg/day, 7%) and very high (≥300 mg/day, 3%) caffeine intakes had an increased risk of their child experiencing excess growth in infancy compared with women with low caffeine intake (<50 mg/day, 46%). There was an association between in utero exposure to caffeine  and higher risk of overweight at age 3 years and 5 years, this association persisted at 8 years, only for very high exposures. The researchers concluded that "any caffeine consumption during pregnancy is associated with a higher risk of excess infant growth and of childhood overweight, mainly at preschool ages."  Source:  http://bmjopen.bmj.com/content/8/3/e018895
In a case-control study in older adults, it was observed a robust association between exposure to different classes of anticholinergic drugs and future dementia incidence.  The researchers used a large UK primary care database, Clinical Practice Research Datalink, and matched 40,770 older adults with a diagnosis of dementia to 283,933 controls without dementia. Until dementia diagnosis (4 to 20 years), an anticholinergic drug with a high anticholinergic burden (e.g., amitriptyline, paroxetine) were prescribed in 36% of cases and 30% of controls. It was found that increasing exposure to highly anticholinergic drugs was associated with increased dementia risk. The risk was highest with antidepressants, anti-Parkinson drugs, and urologic drugs. The researchers concluded that "Clinicians should continue to be vigilant with respect to the use of anticholinergic drugs, and should consider the risk of long term cognitive effects, as well as short term effects, associated with specific drug classes when performing their risk-benefit analysis." Source:  https://www.bmj.com/content/361/bmj.k1315
In a prospective study conducted on 104,980 participants aged at least 18 years from the French NutriNet-Santé cohort (2009-2017), a significant increase in overall and breast cancer was associated with an increase in the proportion of ultra-processed foods in the diet. Source: http://www.bmj.com/content/360/bmj.k322.long

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Burcu Tokuç
The World Health Organization recently published a list of ten threats to global health in the year 2019. These include outbreaks of vaccine-preventable diseases, increased reports of drug-resistant pathogens, increased rates of obesity and physical inactivity, health effects of climate change and environmental pollution, and multiple humanitarian crises. What do these problems mean to Turkey?
Marina Ruxandra Otelea, Adrian Streinu-Cercel, Cristian Băicus, et al.
We recruited 93 non-obese healthy young adults to determine the relation between adipose tissue dysfunction and the cardiometabolic risk indicators. An abnormal adipokine profile (high leptin-to-adiponectin ratio) was considered as a marker of a dysfunctional adipose tissue. We found a direct correlation between the abnormal adipokine profile…
Enayatollah Homaie Rad, Elham Ehsani-Chimeh, Masoumeh Najafi Gharebehlagh, et al.
In recent decades, the role of women in the organizations of developed and less developed countries has increased, but little is known about gender gap in salaries of Iranian physicians. Thirty thousand eight hundred and twenty-four records about characteristics of study population were extracted from national human resources for health database.
Songül Şahin, Şebnem Batur, Övgü Aydın, et al.
The aim of the present study was to evaluate PD-L1 expression and its effect on the prognosis and the relationship with clinicopathologic data in patients with non-small cell lung carcinoma. Thirty-four out 208 cases (16.3%) had PDL-1 positive staining. PDL-1 expression was observed in patients with non-small cell lung carcinoma independent of the histological type…
Figen Kuloğlu, Alper Akın Gözübüyük, Mehmet Kara, et al.
A 34-year-old female presented to our hospital with high fever (39.5 °C), a dark brown lesion on the dorsal side of her right hand, erythema on the medial side of her right arm extending from her right hand to axilla, right axillary lymphadenopathy, and pain in her right arm. She had a history of contact dermatitis on her hands for many years…

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A 31-year-old singleton pregnant woman (gravida 2, para 1) was admitted to the Maternal–Fetal Medical Center, at 30 + 1 weeks of gestation, with a suspicion of fetal congenital heart disease. Prenatal echocardiography exhibited parallel initial segments of the aorta pulmonary arteries. The aorta originated from the right ventricle…

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The effort to maintain the editorial freedom has posed distinct challenges arising from regional dynamics in the Balkan region, as in any part of the world. For a journal to be successful in the international arena, reasonably organized managerial processes are required. Clear definitions of work packages, workflows, duties and responsibilities, and assignment and dismissal criteria are essential for the transparency of managerial processes. The journal’s owner, editor-in-chief, editorial board, publisher, and authors effectively communicating with each other within the framework of rules will prevent chaotic and destructive conflicts that may harm the reputation and its mission. The attempt to establish a legal regulation, an agreement between the owner and the editor, and an ombudsman began approximately five years ago for Balkan Medical Journal. Throughout this process, the journal’s management has endeavored to consult the opinions of the journal’s owner and the university legal regulation committee to establish a legal regulation for the journal that is ethical, practical, sustainable, and conforms to the national laws and international scientific values. We believe the journal legal regulation, finalized in January 2019 and presented below, serves as a role model for all scientific circles and the Balkans and will contribute to the advancement of institutional scientific publications of medicine in the region. The journal’s editorial board extends its gratitude to all current and past employees, the Dean’s of the Faculty of Medicine of Trakya University, and to the current rectorate of Trakya University for their valuable contributions and encouragement to building the development of the journal legal regulation to protect editorial freedom and provide successful journal management of all Trakya University scientific journals.  
Balkan Medical Journal follows ICMJE recommendations. The ICMJE require authors to submit a data-sharing statement for randomized clinical trials. Authors must provide a data-sharing notification to indicate whether data will be shared. According to ICMJE “Data sharing statements must indicate the following: whether individual deidentified participant data (including data dictionaries) will be shared; what data in particular will be shared; whether additional, related documents will be available (e.g., study protocol, statistical analysis plan, etc.); when the data will become available and for how long; by what access criteria data will be shared (including with whom, for what types of analyses, and by what mechanism)” (for details: http://www.icmje.org/recommendations/browse/publishing-and-editorial-issues/clinical-trial-registration.html). Balkan Medical Journal require authors to submit a data-sharing statement and register a data-sharing plan when registering a clinical trial on or after Jan 1, 2019.