Artificial Intelligence (AI) is reshaping healthcare through advancements in clinical decision support and diagnostic capabilities. While human expertise remains foundational to medical practice, AI-powered tools are increasingly matching or exceeding specialist-level performance across multiple domains, paving the way for a new era of democratized healthcare access. These systems promise to reduce disparities in care delivery across demographic, racial, and socioeconomic boundaries by providing high-quality diagnostic support at scale. As a result, advanced healthcare services can be affordable to all populations, irrespective of demographics, race, or socioeconomic background. The democratization of such AI tools can reduce the cost of care, optimize resource allocation, and improve the quality of care. In contrast to humans, AI can potentially uncover complex relationships in the data from a large set of inputs and generate new evidence-based knowledge in medicine. However, integrating AI into healthcare raises several ethical and philosophical concerns, such as bias, transparency, autonomy, responsibility, and accountability. In this study, we examine recent advances in AI-enabled medical image analysis, current regulatory frameworks, and emerging best practices for clinical integration. We analyze both technical and ethical challenges inherent in deploying AI systems across healthcare institutions, with particular attention to data privacy, algorithmic fairness, and system transparency. Furthermore, we propose practical solutions to address key challenges, including data scarcity, racial bias in training datasets, limited model interpretability, and systematic algorithmic biases. Finally, we outline a conceptual algorithm for responsible AI implementations and identify promising future research and development directions.

The purpose of this study was to investigate the possible role of PON-1, an antioxidant lipophilic enzyme linked to HDL-C (high-density lipoprotein cholesterol), on the pathophysiology and clinical follow-up of acute pancreatitis. Biochemical tests, PON-1 and oxidative stress parameters (malonyl dialdehyde, MDA; superoxide dismutase, SOD; total antioxidant capacity, TAC) were evaluated in the sera of patients with acute pancreatitis at admission (day 0), day 3 and day 10 of follow-up, between June and September 2017. SPSS 13.0 statistical software package programme was used for statistical analyses.Mean age was 51.4 of the total 25 patients. Ranson scores were 0–1 points (60%), 3–4 points (24%) and 5–6 points (16%). CTSI (computed tomography severity index) scores were calculated, and most of the patients were seen to have mild or average pancreatitis (96%). While total cholesterol, triacylglycerol and LDL-C (low-density lipoprotein) levels stayed in their normal limits, there was a significant decrement tendency. HDL-C level was seen to rise significantly above its upper limit at day 10 (p < 0.001). Mean PON-1 levels were measured as 69.23, 76.72 vs. 113.15 U/mL at days 0, 3 and 10, respectively; and it was positively correlated with HDL-C (p < 0.001). Serum SOD increased also in parallel with PON-1 (20.49 vs. 39.46 U/mL) while MDA level decreased significantly (3.9 vs. 2.28 μM, p < 0.001). TAC was seen to rise significantly after treatment (0.52 vs. 1.22 mM). In conclusion, decreased PON-1 and HDL-C together with antioxidants SOD and TAC at the early period of acute pancreatitis were seen to rise after treatment, while the previously higher MDA level decreased in parallel. This reveals the importance of the balance between oxidative stress and antioxidant defense mechanisms in clinical progression of the disease, and the potential of PON-1 as a promising clinical marker.

Background and Objectives: Ingrown toenail frequently causes pain and infection and may recur following surgical treatment. This study compared a nail-preserving strategy, minimal matricectomy combined with lateral longitudinal excision, against total nail avulsion for recurrence and clinical outcomes, using propensity-score analysis to address non-randomized treatment allocation. Materials and Methods: In this two-center retrospective cohort study, 412 patients treated between January 2020 and December 2024 were classified according to the surgical procedure received: minimal matricectomy with lateral longitudinal excision (n = 233) or total nail avulsion (n = 179). The primary endpoint was recurrence; secondary outcomes included postoperative pain, healing time, infection, reintervention, return to activity, and patient satisfaction. Inverse probability of treatment weighting (IPTW) was used as a sensitivity analysis, and recurrence-free survival was assessed using the Kaplan–Meier method with the log-rank test. Results: Over a mean follow-up of 18 months, recurrence occurred in 1.7% (n = 4) of the minimal matricectomy group versus 12.3% (n = 22) of the avulsion group (p < 0.001; crude OR 8.0, 95% CI 2.7–23.7). After IPTW adjustment, the association remained consistent (adjusted OR 7.4, 95% CI 2.6–21.3; standardized mean differences <0.10 for all covariates). Kaplan–Meier analysis confirmed significantly higher recurrence-free survival with minimal matricectomy (log-rank p < 0.001). Reintervention (1.3% vs. 9.5%) and return to normal activity (5 vs. 9 days) also favored minimal matricectomy, with lower pain scores, shorter healing, fewer infections, and higher satisfaction. Conclusions: Minimal matricectomy combined with lateral longitudinal excision was associated with lower recurrence and improved clinical outcomes compared with total nail avulsion. This association remained statistically significant after propensity score adjustment for measured baseline covariates. Prospective randomized studies are warranted to confirm these findings.

AIM: Anastomotic leakage (AL) is a life-threatening complication of colorectal surgery carrying significant risks of postoperative morbidity and mortality. Timely identification of patients at elevated risk for AL is critical for optimizing surgical outcomes. This study aimed to evaluate factors associated with AL and to assess the predictive utility of the postoperative day 3 C-reactive protein-to-albumin ratio (CAR) in patients undergoing elective right hemicolectomy for colon cancer.METHODS: This retrospective observational cohort study included patients who underwent elective right hemicolectomy with primary ileocolic anastomosis for colon cancer at Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital (January 2020 to January 2025). Patients undergoing emergency surgery, multivisceral resection, diverting stoma formation, or with incomplete data were excluded. ROC curve analysis and limited univariable logistic regression were used to evaluate the predictive performance of postoperative day 3 CAR.RESULTS: A total of 194 patients were included, and AL developed in 14 patients (7.2%). No significant differences were observed between groups regarding age, body mass index, operative duration, surgical technique, or comorbidities, confirming the homogeneity of the study population. Early enteral feeding was initiated significantly later in patients with AL (3.36 ± 0.74 vs. 2.83 ± 0.76 days, p = 0.021). Postoperative day 3 C-reactive protein (CRP) levels were significantly higher in the AL group (451.3 [398.7–534.2] mg/L vs. 98.4 [71.2–138.6] mg/L, p < 0.001), whereas serum albumin levels were significantly lower (2.30 ± 0.16 g/dL vs. 3.09 ± 0.34 g/dL, p < 0.001). The postoperative day 3 CAR was markedly elevated in patients with AL compared with those without leakage (196.4 [168.2–248.7] vs. 32.1 [22.4–45.8], p < 0.001). Receiver operating characteristic (ROC) curve analysis demonstrated strong predictive performance for CAR, with an area under the curve (AUC) of 0.91 (95% CI: 0.84–0.98, p < 0.001). The optimal cutoff value was 148.7, yielding a sensitivity of 85.7% and specificity of 88.3%. In limited univariable logistic regression analysis, postoperative day 3 CAR remained significantly associated with AL (odds ratio [OR]: 6.84, 95% CI: 3.11–11.52, p < 0.001).CONCLUSIONS: On postoperative day 3, CAR demonstrated strong discriminatory performance for anastomotic leakage after elective right hemicolectomy in this retrospective cohort. The high negative predictive value (98.8%) suggests potential utility as a rule-out tool for early postoperative risk stratification; however, these findings require prospective multicenter validation before any clinical implementation can be considered.