Turkish Journal of Gastroenterology最新文献

{"title":"Machine Learning-Based Prediction of Histopathological Classification in Colorectal Polyps.","authors":"Gökhan Koker, Gizem Zorlu Gorgulugil, Muhammed Ali Coskuner, Merve Eren Durmus","doi":"10.5152/tjg.2025.25542","DOIUrl":"10.5152/tjg.2025.25542","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"36 10","pages":"700-707"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Educational Brochures on Preprocedural Anxiety in Pediatric Endoscopy: A Randomized Controlled Trial.","authors":"Selin Erel, Aslıhan Güleç Kılıç, Nuray Camgöz Eryılmaz, Ülgen Öztürk Toyran, Ödül Eğritaş Gürkan","doi":"10.5152/tjg.2025.25144","DOIUrl":"10.5152/tjg.2025.25144","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"680-691"},"PeriodicalIF":1.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-539-5p Regulates Irritable Bowel Syndrome Pathological Processes by Targeting KDM6A.","authors":"Yiqun Li, Zhiyu Wang, Shuangshuang Zhang, Yanling Hua, Xinting Fan, Li Li","doi":"10.5152/tjg.2025.24684","DOIUrl":"https://doi.org/10.5152/tjg.2025.24684","url":null,"abstract":"<p><p>Background/Aims: The chronicity and recurrence of irritable bowel syndrome (IBS) pose significant burdens on patients' lives, making it urgent to understand its underlying mechanisms. This study intends to investigate the function and regulatory mechanisms of miR-539-5p in IBS and lay the foundation for the creation of more effective therapeutic strategies. Materials and Methods: Rat model of IBS with diarrhea (IBS-D) was established and evaluated by the abdominal withdrawal reflex. The IBS cellular model was established in vitro using lipopolysaccharide (LPS), and real-time quantitative polymerase chain reaction was used to assess the changes in the miR-539-5p expression. Cell counting kit-8 assays, flow cytometry, and enzyme-linked immunosorbent assay were used to evaluate the effects of different treatments on cell viability, paracellular permeability, apoptosis, and inflammatory responses. Bioinformatics techniques and dual-luciferase reporter gene assays were leveraged to forecast and confirm the interaction between miR-539-5p and the KDM6A gene. Results: In IBS-D rats, miR-539-5p was conspicuously downregulated, and miR-539-5p overexpression could improve the symptoms of rats. Under exposure to LPS, the expression of miR-539-5p was evidently decreased. Upregulating miR-539-5p could significantly mitigate LPS-induced cellular damage, namely inhibiting the apoptosis of intestinal mucosal epithelial cells, promoting cell proliferation, reducing paracellular permeability, and suppressing the inflammatory response. KDM6A, as the target gene of miR-539-5p, was remarkably upregulated in IBS-D rats and cells exposed to LPS. KDM6A overexpression counteracts the protective effects mediated by the upregulation of miR-539-5p. Conclusion: miR-539-5p may be involved in regulating the pathological processes of IBS-D by targeting KDM6A.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Arterial Infusion of Nafamostat Mesylate and Lidocaine in the Treatment of Cerulein-Induced Acute Pancreatitis in Rats.","authors":"Ryszard Antkowiak, Łukasz Antkowiak, Zbigniew Arent, Bogna Drozdzowska, Anna Kasperczuk, Jacek Bialecki, Agnieszka Pietsch-Fulbiszewska, Agata Cieslik-Bielecka, Pawel Domoslawski","doi":"10.5152/tjg.2025.24493","DOIUrl":"https://doi.org/10.5152/tjg.2025.24493","url":null,"abstract":"<p><p>Background/Aims: The effectiveness of nafamostat for treating acute pancreatitis (AP) remains questionable. It was hypothesized that the administration of lidocaine would increase the penetration of nafamostat into the pancreas and improve its efficacy. This study evaluated the efficacy of combined management with nafamostat and lidocaine in the treatment of AP. Materials and Methods: Mild edematous AP was induced with cerulein in Wistar rats, which were distributed among 3 interventional cohorts: (1) a lidocaine cohort, with a regional intraarterial infusion of 1% lidocaine solution, (2) a lidocaine-nafamostat group, with a regional intraarterial infusion of 1% lidocaine solution followed by the infusion of nafamostat mesylate, and (3) an NaCl group, with a regional intraarterial infusion of 0.9% sodium chloride solution. Following 4, 8, and 12 hours after drug administration, serum amylase and lipase levels were tested. Rats were euthanized, and the pancreas was removed for histopathological examination. Results: A total of 16 rats were analyzed: 6 in the lidocaine group, 5 in the lidocaine-nafamostat group, and 5 in the NaCl group. Post-treatment amylase and lipase levels were comparable between the groups. The NaCl group had more prevalent signs of chronic inflammation in the pancreatic tissue and adipose tissue than both the lidocaine and lidocaine-nafamostat groups. Conclusion: The addition of nafamostat mesylate did not show superiority over lidocaine alone in the treatment of AP. Considering the prolonged observation period and self-healing tendency of mild edematous AP, both lidocaine and nafamostat do not impact treatment outcomes. However, both drugs may reduce the inflammatory and necrotic processes triggered by AP.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Life Experience of Hepatitis C Treatment with Direct-Acting Antivirals in Genotypes 2 and 3.","authors":"Sibel Yıldız Kaya, Behice Kurtaran, Nefise Öztoprak Çuvalcı, Yusuf Önlen, Mehmet Reşat Ceylan, Esra Zerdali, Nagehan Didem Sarı, Ahsen Öncül, Nurettin Erben, Ayse Batirel, Dilara İnan, Süheyla Kömür, Figen Sarıgül Yıldırım, Hasibullah Yaqoobi, Ferit Kuscu, Rahmet Guner, Fehmi Tabak","doi":"10.5152/tjg.2025.24751","DOIUrl":"https://doi.org/10.5152/tjg.2025.24751","url":null,"abstract":"<p><p>Background/Aims: This study evaluates the efficacy and safety of direct-acting antivirals (DAAs) in treating hepatitis C virus (HCV) genotype 2 (GT-2) and genotype 3 (GT-3) in Türkiye. Materials and Methods: This cohort is a multicenter, retrospective, and observational study. Data from 267 GT-2 or GT-3 patients treated with a DAA were analyzed. Results: An overall sustained virological response (SVR) rate of 95.9%, with no significant difference between GTs. The SVR rates were relatively lower in patients with cirrhosis. Prior pegylated interferon and ribavirin reduced SVR rates, particularly in males and patients with cirrhosis. The most common treatments were sofosbuvir-based regimens, which demonstrated comparable efficacy. No significant drug interactions were observed. The most commonly reported adverse events were fatigue and mild anemia, particularly in cirrhotic patients; however, these did not lead to treatment discontinuation. Conclusion: This study supports the efficacy and tolerability of DAA regimens for these HCV GTs, thereby reinforcing their role in HCV eradication.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wheat-Related Gastrointestinal Diseases: Narrative Review.","authors":"Umael Khan, Gülen Arslan Lied","doi":"10.5152/tjg.2025.25375","DOIUrl":"10.5152/tjg.2025.25375","url":null,"abstract":"<p><p>Intolerance to wheat and gluten intake has gained public and scientific interest in recent years. Celiac disease (CD) and wheat allergy are wheat-related disorders with a well-defined etiological mechanism alongside corresponding diagnostic tests. In addition, patients also self-report intolerance toward wheat and gluten that does not meet the criteria of CD and wheat allergy. This gives rise to a third category, namely non-celiac wheat sensitivity (also referred to as non-celiac gluten sensitivity). However, this category is controversial. Unlike CD and wheat allergy, the pathophysiological mechanism is unknown. When conducting double-blinded placebo-controlled trials, only a small proportion of patients can correctly identify gluten from a placebo based on symptoms, indicating a substantial nocebo component. In fact, it has been posited that non-celiac wheat sensitivity is simply a form of irritable bowel syndrome. The aim of this review is to provide an overview of the epidemiology, etiology, clinical manifestations, diagnosis, and management of the 3 abovementioned conditions.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"36 9","pages":"540-546"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects and Adverse Reactions of Different Bowel Cleansers on Gut Microbiota After Colonoscopy.","authors":"Jiabin Hu, Xiongqun Peng, Shuang Cai, Jiaojiao Qiu, Shuxia Wang, Ping Zhu","doi":"10.5152/tjg.2025.25150","DOIUrl":"10.5152/tjg.2025.25150","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"36 10","pages":"620-628"},"PeriodicalIF":1.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Natural Products Against Alcoholic Liver Fibrosis.","authors":"Shuangjiao Li, Tao Jiang, Wangdong Fan, Peiyao Liu, Lin Huang","doi":"10.5152/tjg.2025.25154","DOIUrl":"10.5152/tjg.2025.25154","url":null,"abstract":"<p><p>Globally, alcoholic beverages top the charts in both sales and consumption rates. However, prolonged intake of these drinks often leads to hepatic injury, potentially progressing to more severe conditions such as hepatic fibrosis, cirrhosis, and in extreme cases, hepatocellular carcinoma. Over the past 2 decades, pharmacological research has increasingly validated the therapeutic potential of natural botanicals and their bioactive derivatives in the clinical management of hepatic fibrosis. In this review, anti-fibrotic secondary metabolites targeting alcohol-induced liver injury have been systematically analyzed, focusing on their botanical origins, pharmacodynamic profiles, structural characteristics, and mechanistic underpinnings. It provides some reference for developing natural products in the treatment of liver fibrosis in the future.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"36 8","pages":"479-487"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Know Thy Kit-Why Catheter Design Matters!","authors":"Henriette Heinrich","doi":"10.5152/tjg.2025.0201255","DOIUrl":"10.5152/tjg.2025.0201255","url":null,"abstract":"","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"36 8","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectopic Gastric Mucosa in the Rectum: An Underrecognized Cause of Rectal Bleeding.","authors":"Fatih Kıvrakoğlu, Mustafa Ergin, Mehmet İbiş","doi":"10.5152/tjg.2025.25133","DOIUrl":"10.5152/tjg.2025.25133","url":null,"abstract":"","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"36 9","pages":"618-619"},"PeriodicalIF":1.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}