Background: Early risk assessment in non-variceal upper gastrointestinal bleeding (NVUGIB) is essential for guiding clinical management. The neutrophil percentage-to-albumin ratio (NPAR) has recently been proposed as a marker reflecting both inflammatory response and physiological reserve. This study aimed to evaluate the prognostic value of NPAR for in-hospital mortality and its relationship with established risk scores in patients with NVUGIB. Methods: This retrospective observational study included 94 patients hospitalized with NVUGIB. NPAR was calculated using laboratory parameters obtained at admission. Patients were stratified according to AIMS65 (<2 vs. ≥2) and Rockall (<5 vs. ≥5) scores. In addition, inflammation-based indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were calculated. Predictive performance was evaluated using receiver operating characteristic (ROC) curve analysis, and associations with clinical outcomes were assessed. Results: The in-hospital mortality rate was 12.8%. NPAR values were significantly higher in patients with AIMS65 ≥ 2 and Rockall ≥ 5 (p < 0.001 for both). NPAR demonstrated good discriminative ability for AIMS65 ≥ 2 (AUC: 0.843) and moderate performance for Rockall ≥ 5 (AUC: 0.714). For mortality prediction, NPAR showed excellent performance (AUC: 0.900). A cut-off value of 27.4 yielded a sensitivity of 91.7% and a specificity of 75.6%. Higher NPAR values were associated with increased mortality risk (OR 31.9, 95% CI: 3.88–102.59, p < 0.001), while the negative predictive value was high (98.4%). In contrast, NLR, PLR, and SII showed limited predictive value for in-hospital mortality. Conclusions: NPAR shows promise as a potential prognostic biomarker for assessing disease severity and in-hospital mortality in NVUGIB. Its high negative predictive value and association with established risk scores suggest that it may complement current risk stratification approaches. However, these findings should be considered preliminary, given the retrospective design and limited sample size, and require validation in larger prospective studies.

Gastroenteroloji pratiğinde çoğunlukla gözden kaçan ve hastaların takibinde önemli bir morbidite nedeni olabilen osteoporozun, uzayan yaşam süresi neticesinde sıklığı giderek artmaktadır. Gastroenterolojik hastalıklardan inflamatuar barsak hastalığı, çölyak hastalığı, malabsorbsiyon sendromları, kronik karaciğer hastalıkları gibi klinik durumlarda artmış sıklıkta osteoporoz ve azalmış kemik mineral yoğunluğu gözlenebilmektedir. Bu durumun kronik inflamasyon, bozulmuş kalsiyum metabolizması gibi bir çok nedene bağlı olabileceği düşünülmektedir. Bunun yanında hastalıkların takibinde kullanılan özellikle glukokortikoid gibi ilaçlara sekonder gelişen osteoporozun yönetimi de klinik takibi gerekli durumlardandır. Osteoporoz tanısı alan her hastada yaşam tarzı değişiklikleri, yaşa ve komorbiditelerine uygun yeterli kalsiyum ve D vitamini replasmanı önerilmeli, tedavi seçimleri hasta bazında bireyselleştirilmelidir. Hastanın yaşı, kemik kırık riski, frajilite kırığı olup olmaması ve sekonder osteoporoz nedenlerinin varlığı hasta takibi ve tedavi kararında belirleyici rol oynamaktadır. Özellikle sekonder osteoporozu olan hastalarda tek başına kemik mineral yoğunluğu ölçümünün hasta takibinde yetersiz olabileceği konusunda klinik bilinç oluşturulmalıdır. Osteoporozdan korunma yaklaşımının yaygınlaştırılması, osteoporoz tanısı alan hastaların etkin tedavisi ile osteoporoza bağlı gelişebilecek mortalite ve morbiditelerin önüne geçilmesi temel hedef olarak belirlenmelidir.

Background: Early identification of disease severity in acute pancreatitis (AP) remains a major clinical challenge. The neutrophil percentage-to-albumin ratio (NPAR) is a novel inflammatory index that reflects systemic inflammation, but evidence regarding its role in predicting AP severity remains limited. This study aimed to evaluate the association between admission NPAR and AP severity and to compare its predictive performance with other inflammatory indices. Methods: This retrospective study included 261 patients with AP. NPAR, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and the systemic immune inflammation index (SII) were calculated using laboratory parameters obtained at hospital admission. Disease severity was assessed according to the revised Atlanta classification and the Bedside Index for Severity in Acute Pancreatitis (BISAP) score. Receiver operating characteristic (ROC) curve analysis was performed to compare predictive performance, and logistic regression analyses were used to identify independent predictors of disease severity. Results: Admission NPAR values were significantly higher in patients with moderately severe/severe AP according to the revised Atlanta classification and in patients with BISAP scores ≥ 3 (both p < 0.001). Among the evaluated inflammatory indices, NPAR demonstrated the highest predictive performance for disease severity according to both the revised Atlanta classification (AUC: 0.808) and BISAP score (AUC: 0.841). In multivariate logistic regression analysis, admission NPAR remained independently associated with AP severity (OR: 1.279, 95% CI: 1.174–1.393, p < 0.001). Admission NPAR levels were also significantly higher in non-survivors than in survivors (p = 0.017). Conclusions: Admission NPAR appears to be a simple, inexpensive, and readily available inflammatory index associated with disease severity in patients with AP. These findings suggest that NPAR may serve as a useful adjunctive tool for early risk stratification. However, larger prospective multicenter studies are required to validate these findings and confirm the proposed admission cut-off value before routine clinical implementation.

Background/Objectives: Terminal ileal nodular lymphoid hyperplasia (NLH) can mimic Crohn’s disease endoscopically, and data integrating its clinical, laboratory, endoscopic, and histopathological features in adults are limited. We aimed to describe these features and associated conditions. Methods: This retrospective single-center study included adults who underwent colonoscopy between January 2023 and December 2025 with terminal ileal biopsy for endoscopically suspected NLH; histopathological confirmation was required for inclusion. Giardia lamblia (G. lamblia)–positive and –negative patients were compared as a secondary exploratory analysis. Results: Histology confirmed NLH in 50 of 64 biopsied patients (78.1%); 43 with essential inclusion data were analyzed (mean age 35.1 ± 12.0 years; 67.4% male); fecal calprotectin was available in 40. Diarrhea and abdominal pain were leading indications. Findings were predominantly reactive, with no morphological features of lymphoma; one patient with Crohn’s-suggestive features was subsequently diagnosed with Crohn’s disease. No patient had hypogammaglobulinemia or positive celiac serology. G. lamblia infection (10/43, 23.3%) was associated with higher fecal calprotectin (median 36.5 vs. 9.0 µg/g; p = 0.016). Conclusions: On routine histology, adult terminal ileal NLH appears predominantly benign and reactive; however, endoscopic appearance alone was insufficient for diagnosis in one fifth of cases. The G. lamblia–calprotectin association is exploratory and requires confirmation.