Eurasian Journal of Chemical, Medicinal and Petroleum Research

Abstract Introduction: ACVRL1 (ALK1) mutations are critical drivers of pulmonary hypertension, significantly influencing endothelial dysfunction and vascular remodeling. Despite its clinical importance, the precise prognostic impact of ALK1 on disease progression remains insufficiently characterized across diverse populations. This systematic review aims to evaluate the prognostic role of ACVRL1/ALK1 in the development and outcomes of pulmonary hypertension.

Material and methods: This systematic review was conducted according to PRISMA guidelines to evaluate the prognostic role of ACVRL1/ALK1 in pulmonary hypertension. Eligible human studies were systematically identified from international and national databases, screened against predefined inclusion and exclusion criteria, and assessed for methodological quality. Data on study characteristics, sample size, mutation status, hemodynamic parameters, disease progression, survival, and clinical outcomes were extracted using a standardized approach.

Results: Synthesis of 11 studies (n=11; cohort, case-control, and genetic designs) confirms that ACVRL1/ALK1 mutations independently correlate with earlier disease onset and accelerated clinical decline. Carriers exhibited significantly worse hemodynamic profiles (e.g., higher pulmonary arterial pressures) and increased right ventricular strain compared to non-carriers. Qualitative synthesis indicates higher risk stratification scores and diminished survival rates, underscoring ACVRL1 as a pivotal genetic determinant of aggressive pulmonary hypertension phenotypes and poor clinical outcomes.

Conclusion: ACVRL1/ALK1 mutations serve as a critical prognostic biomarker in pulmonary hypertension, identifying a high-risk cohort characterized by early-onset disease and rapid hemodynamic deterioration. Incorporating ACVRL1 genotyping into clinical risk stratification is essential for optimizing surveillance and initiating aggressive, personalized therapeutic interventions. Future prospective multicenter trials are necessary to refine genotype-specific survival estimates and standardize long-term management protocols for this vulnerable patient population.

Abstract Introduction: Femoral implant surgery is frequently complicated by early inflammatory reactions that may be difficult to distinguish from normal postoperative responses. Because C-reactive protein reflects systemic inflammatory activity, preoperative measurement may help identify patients at greater risk of acute pathologic inflammation after surgery. The aim of this study was to evaluate the diagnostic value of preoperative CRP in predicting acute inflammation following femoral implant placement.

Material and methods: This descriptive cross-sectional study was conducted at Shahid Madani Hospital in Tabriz, Iran. Using Cochran’s formula, the sample size was estimated at 73 patients, who were enrolled through convenience sampling. Data were extracted from medical records on demographic characteristics, comorbidities, preoperative CRP and other laboratory findings, operative details, and early postoperative inflammatory outcomes to assess the diagnostic value of preoperative CRP.

Results: Among 73 patients, acute postoperative inflammation occurred in 21.9%. Affected patients had higher preoperative CRP (24.18 vs 12.32 mg/L, P < 0.001), ESR (34.50 vs 25.98 mm/h, P = 0.009), and WBC (9.96 vs 8.40 x10³/muL, P = 0.015), but lower hemoglobin (11.28 vs 12.34 g/dL, P = 0.021) and albumin (3.29 vs 3.70 g/dL, P = 0.003). CRP showed good diagnostic performance (AUC = 0.812, sensitivity 78.9%, specificity 73.6%, NPV 95.1%).

Conclusion: Preoperative CRP appears to be a clinically useful marker for identifying patients at risk of acute inflammation after femoral implant placement. Its strong discriminatory capacity and high negative predictive value suggest particular value in perioperative risk stratification, especially when interpreted alongside comorbidity burden, nutritional status, and operative complexity.

Abstract Introduction: Early infection after femoral implant placement is a serious complication influenced by host immunity, wound healing capacity, and nutritional-inflammatory status. Preoperative serum albumin is a practical biomarker that may reflect vulnerability to postoperative infection, but its predictive accuracy remains uncertain in femoral implant surgery. This study aimed to evaluate the sensitivity and specificity of preoperative serum albumin in predicting early infection after femoral implant placement.

Material and methods: This retrospective descriptive cross-sectional study was conducted at Shahid Madani Hospital, Tabriz, on 125 patients selected by convenience sampling. The sample size was estimated using Cochran’s formula. Data were extracted from medical records to evaluate preoperative serum albumin, demographic and clinical variables, operative characteristics, and early postoperative infection after femoral implant placement, with the aim of assessing the diagnostic performance of albumin in predicting early infection.

Results: Among 125 patients, early postoperative infection occurred in 15.2% (19/125). Infected patients had lower preoperative albumin (3.12 ± 0.46 vs 3.66 ± 0.51 g/dL; P < 0.001), a higher rate of hypoalbuminemia (63.2% vs 27.4%; P = 0.002), lower hemoglobin (P = 0.011), and higher inflammatory markers (WBC, P = 0.018; CRP, P = 0.006). Serum albumin predicted infection with good accuracy (cutoff 3.35 g/dL; sensitivity 78.9%, specificity 73.6%, AUC 0.812, P < 0.001).

Conclusion: Preoperative serum albumin appears to be a clinically useful marker for identifying patients at increased risk of early infection after femoral implant placement. Lower albumin levels were consistently associated with infection and showed acceptable diagnostic performance. These findings support incorporating serum albumin into routine preoperative assessment to improve risk stratification and guide perioperative optimization in this surgical population.

Abstract Introduction: Liver transplantation is a life-saving treatment for end-stage liver disease, but its success depends heavily on accurate pathologic assessment before, during, and after surgery. Pathology helps define native liver disease, assess donor organ quality, and identify causes of graft dysfunction. The aim of this study was to evaluate the pathologic findings in patients undergoing liver transplantation.

Material and methods: This retrospective descriptive cross-sectional study was conducted at Imam Reza Hospital, Tabriz, on 73 liver transplant patients selected by convenience sampling based on the Cochran formula. Data were extracted from archived medical records and pathology reports, and included demographic characteristics, transplant indications, explant pathology, and available post-transplant histopathologic findings to evaluate the spectrum of pathologic changes in this patient population.

Results: Among 73 liver transplant recipients, cirrhosis was the leading transplant indication (32.9%) and the dominant explant finding (71.2%), while advanced fibrosis/cirrhosis was present in 75.3%. Steatosis was identified in 31.5%, cholestasis in 23.3%, and hepatocellular carcinoma in 19.2%. Hepatocellular carcinoma was significantly associated with older age (P = 0.041), viral hepatitis (P = 0.018), pre-transplant cirrhosis (P = 0.047), dysplasia (P = 0.006), vascular abnormalities (P = 0.039), and microvascular invasion (P < 0.001).

Conclusion: These findings indicate that end-stage cirrhotic liver disease constitutes the principal pathologic burden in liver transplant recipients, while hepatocellular carcinoma represents a clinically important subset linked to adverse pathologic features. Careful explant pathologic evaluation is therefore essential not only for confirming the underlying disease spectrum but also for identifying malignant and high-risk microscopic characteristics with prognostic relevance.

Abstract Introduction: Breast cancer remains a major global health burden, and lymph node involvement is a key pathologic indicator of tumor spread, prognosis, and postoperative treatment planning in patients undergoing mastectomy. Accurate nodal assessment also improves disease staging and therapeutic decision-making. This study aims to evaluate the pathologic status of lymph node involvement in patients undergoing mastectomy.

Material and methods: This retrospective descriptive cross-sectional study was conducted at Shahid Madani Hospital in Tabriz on 250 patients selected by convenience sampling, with sample size estimated using Cochran’s formula. Data were extracted from archived medical and pathology records, and clinicopathologic variables, particularly lymph node status and related breast tumor characteristics, were systematically collected and analyzed to evaluate the pattern of nodal involvement in mastectomy patients.

Results: Among 250 mastectomy patients, invasive ductal carcinoma was the predominant subtype (79.2%), most tumors were grade II (57.2%), and mean tumor size was 3.41 ± 1.67 cm. Lymph node involvement was present in 58.4%, with macrometastasis in 51.2% and extranodal extension in 15.6%. Nodal positivity was significantly associated with larger tumor size (3.98 ± 1.78 vs. 2.61 ± 1.14 cm, P < 0.001), higher grade (P = 0.002), and lymphovascular invasion (60.3% vs. 23.1%, P < 0.001).

Conclusion: These findings indicate that lymph node metastasis is common in mastectomy specimens and is closely linked to adverse pathologic features. Larger tumors, higher histologic grade, and lymphovascular invasion appear to be the strongest correlates of nodal spread, underscoring the importance of careful pathologic lymph node assessment for accurate staging, prognostic stratification, and postoperative treatment planning in breast cancer patients.

Abstract Introduction: Tibial fractures present substantial healing challenges because limited soft-tissue coverage, vulnerable blood supply, fracture complexity, and host-related factors increase the risk of impaired union. Although plate fixation restores alignment and stability, it may contribute to infection, nonunion, malunion, and implant-related complications. This study aimed to evaluate healing time and complications following tibial fracture plating from a pathologic perspective.

Material and methods: This descriptive cross-sectional study included 52 patients who underwent plate fixation for tibial fractures at Shahid Madani Hospital, Tabriz, selected through convenience sampling. Demographic, clinical, fracture-related, laboratory, operative, and postoperative data were collected from medical records and follow-up assessments. Healing time was determined using clinical and radiographic evidence of union, while postoperative complications, including infection, impaired union, malalignment, and implant-related failure, were documented.

Results: Patients with postoperative complications were older and had more severe injuries, including higher rates of open and comminuted fractures, longer time to surgery, and worse preoperative inflammatory and nutritional profiles (all significant variables, P<0.05). Healing time was markedly prolonged in complicated cases (23.2 ± 4.6 vs 15.9 ± 3.2 weeks, P<0.001). Independent predictors included age (OR=1.04), open fracture (OR=2.86), CRP (OR=1.17), surgical delay (OR=1.38), and operative duration (OR=1.21).

Conclusion: These findings indicate that postoperative complications after tibial plate fixation are driven by both fracture severity and adverse preoperative biological status. Early surgical management, control of inflammation, and optimization of hemoglobin and albumin levels may improve healing and reduce complication risk. Preoperative CRP and operative burden appear particularly valuable for risk stratification and perioperative decision-making.