Gestational diabetes mellitus (GDM) is a prevalent condition requiring accurate patient education, yet the reliability and readability of large language models (LLMs) in this context remain uncertain. This study evaluated the performance of four LLMs—ChatGPT-4o, Gemini 2.5 Pro, Grok 3.0, and DeepSeek R-1—using 25 patient-oriented questions derived from clinical scenarios. Seven endocrinologists independently rated the responses with the modified DISCERN (mDISCERN) instrument and the Global Quality Score (GQS). Readability was analyzed using the Flesch Reading Ease (FRES), Flesch–Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman–Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG), while lexical diversity was assessed through type–token ratio (TTR). Grok and Gemini obtained the highest mDISCERN and GQS scores, whereas ChatGPT performed significantly lower (p < 0.05). DeepSeek generated the most readable outputs, while Grok provided the longest and most complex responses. All models scored below the FRES threshold of 60 recommended for lay audiences. Response length showed strong positive correlations with mDISCERN and GQS, while TTR was inversely related to quality but positively associated with readability. These findings highlight variability among LLMs in GDM education and emphasize the need for model-specific improvements to ensure reliable patient-facing health information.

Context: The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. Methods: This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19–related SAT (Cov-SAT), SARS-CoV-2 vaccine–related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. Results: Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid peroxidase (TPO) positivity, and absence of steroid therapy were statistically significant predictors of incident (early) hypothyroidism, irrespective of SAT etiology. On the other hand, probable predictors of established hypothyroidism differed from that of incident hypothyroidism. Conclusion: Since there is no difference in terms of follow-up parameters and outcomes, COVID-19– and SARS-CoV-2 vaccine–related SAT can be treated and followed up like classic SATs. Recurrence was determined by younger age and steroid therapy requirement. Steroid therapy independently predicts incident hypothyroidism that may sometimes be transient in overall SAT and is also associated with a lower risk of established hypothyroidism.

SUMMARY Dilated cardiomyopathy (DCM) is characterized by systolic dysfunction and is usually idiopathic. A rare cause of reversible DCM is hypocalcemia. Calcium plays a key role in myocardial contraction. Hypocalcemia can lead to a decrease in contraction, left ventricular systolic dysfunction, and heart failure with reduced ejection fraction (EF). Hypocalcemia-related reversible DCM reports are rare. Herein, we present two cases with heart failure caused by hypocalcemia developed due to hypoparathyroidism. The first case presented with severe heart failure and an [...] SUMMARY Dilated cardiomyopathy (DCM) is characterized by systolic dysfunction and is usually idiopathic. A rare cause of reversible DCM is hypocalcemia. Calcium plays a key role in myocardial contraction. Hypocalcemia can lead to a decrease in contraction, left ventricular systolic dysfunction, and heart failure with reduced ejection fraction (EF). Hypocalcemia-related reversible DCM reports are rare. Herein, we present two cases with heart failure caused by hypocalcemia developed due to hypoparathyroidism. The first case presented with severe heart failure and an

Background/Aims: Elevated intra-abdominal pressure (IAP) can lead to intra-abdominal hypertension (IAH) and, in severe cases, abdominal compartment syndrome (ACS) in patients with cirrhosis and ascites. Paracentesis reduces IAP and improves abdominal perfusion. Intra-abdominal hypertension can also trigger acute-on-chronic liver failure (ACLF) in decompensated cirrhosis. This study evaluates the association between IAH and short-term mortality in patients with cirrhosis and ascites. Materials and Methods: This prospective, single-center cohort study included 18 patients (7 females, 11 males; median age: 59) sched uled for therapeutic paracentesis. Intra-abdominal pressure was measured using the bladder technique. Patients were grouped based on initial Chronic Liver Failure Consortium Organ Failure (CLIF-C OF) scores as ACLF or non-ACLF and followed up for 3 months. Results: The median model for end-stage liver disease score was 17 (IQR 11-19). The primary etiologies of cirrhosis were viral hepatitis and alcoholic liver disease. Independent risk factors for IAH included advanced liver disease and large-volume ascites. Pre paracentesis IAP was higher in ACLF patients (22 vs. 18 mm Hg). Post-paracentesis IAP was also higher in ACLF patients (14 vs. 8 mm Hg, P = .007). The 3-month mortality rate was 50%, with worse survival in ACLF patients (24 vs. 76.9 days, P = .002). Pre-paracentesis IAP was signifi cantly higher in patients who died (22 vs. 18 mm Hg, P = .034), and survival was worse in those with IAP #18.5 mm Hg (P = .026). Conclusion: Intra-abdominal pressure is elevated in cirrhosis patients with grade 3 ascites. Despite similar paracentesis volumes, IAP remained higher in the ACLF group. Intra-abdominal pressure #18.5 mm Hg is associated with significantly reduced survival, indicating that IAH accelerates short-term mortality in these patients. Cite this article as: Mutlu U, Genc Ulucecen S, Iliaz R, et al. Intra-abdominal hypertension and its prognostic impact on mortality in cirrhotic patients with ascites: The role of paracentesis. Turk J Gastroenterol. 2025;36(6):390-397.