The aim of this study is to investigate whether the creeping fat (CF) finding evaluated by computed tomography (CT) can be used as a noninvasive marker to predict disease prognosis.

Acute pancreatitis is a life-threatening disease associated with significant in-hospital mortality, particularly when complications occur. However, there is little data for long-term all-cause mortality of acute pancreatitis and its relation to etiology. Thus, in this study, both short- and very long-term all-cause mortality after acute pancreatitis were sought.

Acute pancreatitis is a life-threatening disease associated with significant in-hospital mortality, particularly when complications occur. However, there is little data for long-term all-cause mortality of acute pancreatitis and its relation to etiology. Thus, in this study, both short- and very long-term all-cause mortality after acute pancreatitis were sought.

Background/Aims: Colorectal polyps are precursor lesions of colorectal cancer, and their histopathological types are critical for determining malignant potential. Predicting polyp histopathological types may support early and appropriate clinical management. Machine learning (ML) algorithms based on accessible demographic, clinical, and lifestyle data can contribute to individualized screening strategies. Materials and Methods: This retrospective cross-sectional study included 491 individuals who underwent colonoscopy for the first time between 2022 and 2025 at University of Health Sciences, Antalya Training and Research Hospital. Demographic and clinical data were recorded, and dietary habits were assessed using the Food Frequency Questionnaire. Patients were classified into 3 groups according to histopathology: adenomatous polyp, hyperplastic polyp, and no polyp. Four ML algorithms-decision tree, random forest, support vector machines (SVMs), and extreme gradient boosting-were applied. Model performance was evaluated using accuracy, sensitivity, specificity, kappa statistic, and McNemar's test. Variable contributions were further analyzed with SHapley Additive exPlanations. Results: Accuracy ranged from 70.9% to 76.4%, with the highest performance from SVM (76.4%) and random forest (75.7%). Extreme gradient boosting showed lower overall accuracy (70.9%) but was the only model that identified hyperplastic polyps. The no polyp group was consistently predicted with high accuracy (sensitivity 85.6%-95.9%). Precision for adenomatous polyps was highest with SVM (71.4%). SHapley Additive exPlanations analysis highlighted frequent bulgur consumption (>2 times/week), red meat intake, age, and body mass index as major predictors. Conclusion: Machine learning algorithms can predict colorectal polyp histopathological types using routine demographic, clinical, and dietary data, enabling more personalized and effective screening beyond age-based protocols.

Early diagnosis of cytomegalovirus gastrointestinal disease (CMV-GID) is often deemed critical for the appropriate management of the disease. Although histopathological examination is the gold standard for diagnosis, non-invasive and early diagnostic methods may be needed to predict CMV-GID. As a rapid and non-invasive method, the detection of CMV DNA in plasma by polymerase chain reaction (PCR) can be utilized. In this study, the aim was to determine the optimal plasma CMV DNA cut-off value and to develop a scoring system as an adjunct diagnostic method for predicting CMV-GID.

Patients with hepatitis B-related decompensated cirrhosis may achieve recompensation. The alanine aminotransferase (ALT) to quantitative hepatitis B surface antigen (qHBsAg) ratio is a novel predictor for hepatitis B surface antigen (HBsAg) seroclearance. This study evaluates its utility in predicting recompensation based on Baveno VII criteria.

Background/Aims: Preoperative anxiety is a common and significant issue in pediatric patients undergoing endoscopic interventions. The evaluation aimed to determine whether age-appropriate educational brochures could reduce anxiety in pediatric patients and their caregivers undergoing outpatient endoscopic procedures with sedation. Materials and Methods: Pediatric patients and their caregivers were randomly assigned to either a control group (standard verbal information only) or an intervention group (standard verbal information plus an age-appropriate educational brochure). On the day of the procedure, pediatric anxiety was assessed using the Modified Yale Preoperative Anxiety Scale (m-YPAS), whereas caregiver anxiety was measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Results: A total of 252 pediatric patients (age, 3-17 years; American Society of Anesthesiologists score, I-II) and their caregivers were recruited. Of these, 174 formed the control group and 78 received an educational brochure intervention. The demographic characteristics were similar across the groups, except for caregiver age. While there were no significant between-group differences in caregiver APAIS scores, pediatric patients in the brochure group exhibited significantly lower m-YPAS scores (P < .05) than those in the control group. Conclusion: Providing children with age-appropriate educational brochures prior to sedation for endoscopic procedures significantly reduced their preoperative anxiety. This low-cost, easily implemented intervention may help improve procedural experience in pediatric patients and potentially enhance overall clinical outcomes.

Liver fibrosis is a key intermediate stage in the progression of chronic liver disease to end-stage liver cirrhosis. Mortality rises exponentially once it reaches decompensated liver disease. In a healthy liver microenvironment, hepatocytes, Kupffer cells, hepatic stellate cells (HSCs), liver sinusoidal endothelial cells, and other cells interact with extracellular matrix (ECM) to maintain cell stability and liver function. Different types of liver injury (such as viral hepatitis and alcoholic liver injury) can cause liver fibrosis. Liver injury signals activate Kupffer cells and recruit immune cells, leading to liver inflammation. This inflammation, together with liver injury, stimulates the activation of HSCs. Activated HSCs migrate to injury sites and secrete ECM. The ECM increase and stiffening contribute to fibrosis. Microenvironment changes alter cell phenotypes, perpetuating HSC activation. This article explores liver fibrosis mechanisms, reviews cellular and microenvironmental changes, summarizes fibrosis characteristics, and provides insights for clinical treatment.

Colonoscopy is a pivotal technique for screening and diagnosing colorectal diseases, particularly colorectal polyps and cancers. Early detection of lesions enables early diagnosis and treatment, thereby improving patient prognosis. The adequacy of bowel preparation is directly related to the quality and effectiveness of colonoscopy. However, the bowel cleansing process may disrupt the balance of gut microbiota, subsequently affecting the host's health status. Currently, there is a relative scarcity of reports on the specific impacts of different types of laxatives on gut microbiota. Therefore, this paper aims to deeply analyze and summarize the effects of various bowel preparations on gut microbiota and their potential adverse reactions following colonoscopy, providing a more comprehensive reference for the selection of bowel preparations in clinical practice.

Hepatocellular carcinoma (HCC) stands as the foremost contributor to cancer-related mortality, underscoring its profound significance in the oncological landscape. This study explores the potential regulatory mechanisms of lncRNA CKMT2-AS1 in the functionality of HCC cells, thereby providing a basis for therapeutic approaches in the treatment of HCC.

The aim of this study is to reveal the contribution and clinical usability of endosonography in the differential diagnosis of patients presenting with dysphagia.

Inflammatory bowel diseases (IBDs) are increasingly prevalent and challenging globally. Data regarding IBD frequency and severity between Europe and Asia are needed. The aim was to investigate the trend of IBD in Türkiye during the last 3 decades.

Background/Aims: Liver fibrosis is linked to higher rates of death and disease. This study examined the hepatoprotective properties of vincamine and its potential therapeutic application in treating liver damage caused by methotrexate in rats. Materials and Methods: Thirty male Wistar albino rats, with weights ranging from 150 to 200 g and ages between 10 and 12 weeks, were included in the study. A total of 10 rats were selected to serve as the control group, receiving no medication. A group of 20 rats was given a single intraperitoneal dose of 20 mg/kg methotrexate in order to cause liver damage. Subsequently, the participants were randomly allocated into 2 cohorts and administered either 1 mL/kg/day tap water or 50 mg/kg/day vincamine orally through gavage on a daily basis for a duration of 10 days. Following the completion of the treatment period, the animals were euthanized and their livers were examined histologically. Furthermore, the levels of plasma galectin-3 (gal-3), cytokeratin 18, malondialdehyde (MDA), alanine transaminase (ALT), liver MDA, and transforming growth factor beta (TGF-β) levels were evaluated. Results: Treatment with vincamine resulted in a significant decrease in plasma gal-3, cytokeratin, MDA, and ALT levels and liver MDA and TGF-β levels compared to the methotrexate and saline group. Vincamine treatment effectively protected against liver injury, and histopathological examination of the livers confirmed these results. Conclusion: This study demonstrates that vincamine alleviates methotrexate-induced liver toxicity via exhibiting antioxidant, antiinflammatory, and anti-fibrotic activities and improved liver functionally, biochemically, and histopathologically.

Background/Aims: The role of semi-quantitative strain ratio (SR) using real-time endoscopic ultrasound strain elastography (EUS-E) in chronic liver disease (CLD) and cirrhosis is yet to be determined. Herein, the aim was to assess the usefulness of EUS-E to detect CLD and cirrhosis. Materials and Methods: Patients with cirrhosis and non-cirrhotic CLD were enrolled prospectively. Patients without liver disease and undergoing EUS examinations for non-hepatic indications were taken as control group. Strain ratio was calculated from strains of hepatic vein and liver parenchyma. Fibrosis-4 (FIB-4) and aspartate aminotransferase (AST)-to-Platelet Ratio Index (APRI) scores were recorded, and blood cytokeratin-18 (CK-18) levels were measured to assess hepatic fibrosis. A clinical evaluation was also conducted. Results: One hundred participants (control: 49, CLD: 33, cirrhotic: 18) were included. The SR and liver parenchyma strains in cirrhotics were significantly higher than those in the CLD (P < .001) and control (P < .001) groups. Strain ratio threshold set at 5.67 had a sensitivity of 94.4% and a specificity of 95.9% to differentiate cirrhotics from control patients. An SR threshold of 10.65 had a sensitivity of 94.4% and a specificity of 84.8% in differentiating cirrhotics from CLD patients. The SR showed a strong positive correlation with FIB-4 and APRI scores, but not with CK-18 levels. Conclusions: Strain ratio thresholds of 5.67 and 10.65 obtained by EUS-E are useful to differentiate cirrhotics from non-cirrhotic CLD patients and liver-disease-free subjects, respectively. This pilot study is the first one evaluating the role of EUS-E in liver diseases, and future studies involving patients having CLD of specific etiologies are warranted.

Helicobacter pylori (H. pylori) affects half of the world's population. Increasing antibiotic resistance seems to be causing significant clinical problems. The efficacy of bismuth-containing sequential therapy with clarithromycin (BSTC), bismuth-containing sequential therapy with levofloxacin (BSTL), and bismuth-containing quadruple therapy (BQT) regimens on H. pylori eradication was investigated. The authors also investigated whether high gastric H. pylori colonization density affected treatment success through different treatment regimens.

Oxaliplatin is a frontline chemotherapeutic agent for gastric cancer (GC) patients; yet, its clinical efficacy is often hindered by drug resistance. Recent studies have suggested a link between fatty acid oxidation (FAO) in GC and chemoresistance, but the precise mechanisms remain elusive.

Endoscopic ultrasound (EUS) has become an increasingly important tool in modern medicine, particularly in the diagnosis and treatment of pancreatic pathologies. The aim of this study is to elucidate the diagnostic and predictive roles of EUS in pancreatic cysts.

Background/Aims: This research aimed at probing the mechanism of long non-coding RNA small nucleolar RNA host gene 4 (SNHG4) in regulating lipid metabolism and inflammation in non-alcoholic fatty liver disease (NAFLD). Materials and Methods: L02 and THLE-2 cells were stimulated with free fatty acids (FFA) and transfected. Lipid accumulation was detected through Oil Red O staining, measurements of triglyceride and total cholesterol were taken, and the levels of tumor necrosis factor-α, interleukin (IL)-1β, and IL-6 were assessed using enzyme-linked immunosorbent assays. The assessment of gene expression was conducted using real-time reverse transcriptase-polymerase chain reaction and Western blot techniques. The interplay between SNHG4 and miR-34b-5p/X-linked inhibitor of apoptosis protein (XIAP) was evaluated. Results: Free fatty acids downregulated SNHG4 and XIAP and upregulated miR-34b-5p in L02 and THLE-2 cells, leading to lipid metabolism disorder and inflammation. SNHG4 overexpression mitigated the lipid metabolism disorder and inflammation triggered by FFA, while this effect was suppressed by silencing XIAP. In contrast, SNHG4 knockdown aggravated FFA-induced lipid metabolic and inflammatory disorders, whilst this effect was rescued by inhibiting miR-34b-5p. Conclusion: SNHG4 regulates lipid metabolism and inflammatory disorders in NAFLD by targeting the miR-34b-5p/XIAP axis.

Background/Aims: The study focuses on examining the impact of Helicobacter pylori (H. pylori) on the modulation of the miRNA expression profiles while also unraveling the associated pathways that play a significant role in initiating and driving the development of gastric cancer (GC). Materials and Methods: An in-depth analysis of miRNA expression profiles in gastric tissue samples from patients with chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG), dysplasia (Dys), or GC was conducted. The carbon-13 urea breath test was used to identify H. pylori infection, and the participant cohort was characterized by the presence of H. pylori infection. Additionally, the role of miR-196a/b-5p in GC carcinogenesis was investigated. Results: A total of five miRNAs-miR-196a-5p, 196b-5p, 224-5p, 424-3p, and 941-demonstrated marked elevation in CSG, CAG, Dys, and GC. miR-196a/b-5p was observed to be upregulated in GC cells following H. pylori infection, as well as in Dys and GC tissue samples from patients harboring H. pylori. miR-196a/b-5p can expedite GC progression. Insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1), the target gene of miR-196a/b-5p, diminishes the proliferation capability of GC cells; however, miR-196a/b-5p can partially counteract this effect. miR-196a/b-5p activates the PI3K-Akt pathway, while IGF2BP1 inhibits the expression of these proteins. Conclusion: The levels of miR-196a/b-5p were observed to escalate following H. pylori infection, subsequently fostering the progression of GC by specifically targeting IGF2BP1 and triggering the PI3K-Akt signaling cascade.

Background/Aims: The prevalence of sarcopenia and osteopenia/osteoporosis is increased in chronic pancreatitis (CP). This study aims to evaluate the prevalence and related factors of osteosarcopenia in CP patients. Materials and Methods: Eighty-three CP patients were included in this cross-sectional observational study. Sarcopenia was assessed by measuring the surface area of the paravertebral muscles at the third lumbar region. Pancreatic fecal elastase (PFE) tests evaluated exocrine pancreatic insufficiency (EPI), while dual-energy x-ray absorptiometry scans assessed osteopenia/osteoporosis. EORTC PAN26 and a symptom questionnaire were administered, alongside nutritional marker assessments concurrent with PFE. Results: The prevalence of sarcopenia and osteopenia/osteoporosis was found to be 22.9% (n = 19) and 68.7% (n = 44), respectively. Factors associated with sarcopenia included male gender (OR: 4.9, P = .044), severe EPI (OR: 4.2, P = .043), smoking (OR: 4.6, P = .040), and zinc deficiency (OR: 2.2, P = .029). Severe EPI was significantly associated with osteopenia/osteoporosis (P = .010), diabetes mellitus (P = .001), sarcopenia (P = .016), and zinc deficiency (P = .012). Individuals with osteoporosis had higher PAN26 scores (P = .029). Factors independently associated with osteopenia/osteoporosis included female gender (OR: 7.8, P = .004), severe EPI (OR: 8.1, P = .003), and sarcopenia (OR: 5, P = .037). The prevalence of osteosarcopenia was 19.2%. Conclusion: Osteosarcopenia is common in CP patients. Smoking, zinc deficiency, EPI, and male gender are strongly associated with sarcopenia. Screening for osteosarcopenia is essential in CP patients to facilitate appropriate interventions.