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Topic Review
Human Pluripotent Stem Cell-Based Models for Hirschsprung Disease
Hirschsprung disease (HSCR) is a complex congenital disorder caused by defects in the development of the enteric nervous system (ENS). It is attributed to failures of the enteric neural crest stem cells (ENCCs) to proliferate, differentiate and/or migrate, leading to the absence of enteric neurons in the distal colon, resulting in colonic motility dysfunction. Due to the oligogenic nature of the disease, some HSCR conditions could not be phenocopied in animal models. Building the patient-based disease model using human induced pluripotent stem cells (hPSC) has opened up a new opportunity to untangle the unknowns of the disease. The expanding armamentarium of hPSC-based therapies provides needed new tools for developing cell-replacement therapy for HSCR. 
  • 981
  • 09 Nov 2022
Topic Review
Role of Interleukins in Hepatitis B Virus Infection
Hepatitis B virus (HBV) infection is a worldwide medical issue with significant morbidity and mortality, as it is the main cause of chronic liver disease and hepatocellular carcinoma (HCC). Both innate and adaptive immune responses play a key role in HBV replication and suppression. The pathophysiological function of interleukins (IL) in the natural course of HBV has gained much attention as a result of the broad use of anti-interleukin agents for a variety of autoimmune diseases and the accompanying risk of HBV reactivation.
  • 981
  • 05 Dec 2023
Topic Review
Obesity and Inflammatory Bowel Disease
Inflammatory colon diseases, which are a global health concern, include a variety of gastrointestinal tract disorders, such as inflammatory bowel disease and colon cancer. The pathogenesis of these colon disorders involves immune alterations with the pronounced infiltration of innate and adaptive immune cells into the intestines and the augmented expression of mucosal pro-inflammatory cytokines stimulated by commensal microbiota. Epidemiological studies during the past half century have shown that the proportion of obese people in a population is associated with the incidence and pathogenesis of gastrointestinal tract disorders. The advancement of understanding of the immunological basis of colon disease has shown that adipocyte-derived biologically active substances (adipokines) modulate the role of innate and adaptive immune cells in the progress of intestinal inflammation. 
  • 977
  • 30 Mar 2021
Topic Review
Clinical Presentation of Wilson’s Disease
Wilson’s disease can appear at any age, although it is most prevalent in patients before the age of 40. Most cases are diagnosed between 5 and 35 years of age. Clinical signs and symptoms of the disease may vary considerably but the most common are hepatic (including cirrhosis), neurologic, and psychiatric disorders; ophthalmic signs (Kayser–Fleischer rings); and episodes of hemolysis coexisting with acute liver failure. Due to its heterogeneous presentation, Wilson’s disease has been referred to as “the great masquerader”
  • 977
  • 01 Dec 2021
Topic Review
Pathophysiology of Nitrergic Enteric Neurons
Nitrergic enteric neurons are key players of the descending inhibitory reflex of intestinal peristalsis, therefore loss or damage of these neurons can contribute to developing gastrointestinal motility disturbances suffered by patients worldwide. There is accumulating evidence that the vulnerability of nitrergic enteric neurons to neuropathy is strictly region-specific and that the two main enteric plexuses display different nitrergic neuronal damage. Alterations both in the proportion of the nitrergic subpopulation and in the total number of enteric neurons suggest that modification of the neurochemical character or neuronal death occurs in the investigated gut segments. 
  • 974
  • 23 Jun 2021
Topic Review
Interactions between Nanoparticles and Intestine
The use of nanoparticles (NPs) has surely grown in recent years due to their versatility, with a spectrum of applications that range from nanomedicine to the food industry. Recent research focuses on the development of NPs for the oral administration route rather than the intravenous one, placing the interactions between NPs and the intestine at the centre of the attention. This allows the NPs functionalization to exploit the different characteristics of the digestive tract, such as the different pH, the intestinal mucus layer, or the intestinal absorption capacity. On the other hand, these same characteristics can represent a problem for their complexity, also considering the potential interactions with the food matrix or the microbiota.
  • 974
  • 06 May 2022
Topic Review
Artificial Intelligence for Gastrointestinal Diseases
The development of convolutional neural networks has achieved impressive advances of machine learning in recent years, leading to an increasing use of artificial intelligence (AI) in the field of gastrointestinal (GI) diseases. AI networks have been trained to differentiate benign from malignant lesions, analyze endoscopic and radiological GI images, and assess histological diagnoses, obtaining excellent results and high overall diagnostic accuracy. Nevertheless, there data are lacking on side effects of AI in the gastroenterology field, and high-quality studies comparing the performance of AI networks to health care professionals are still limited.
  • 973
  • 24 Sep 2021
Topic Review
Primary Liver Cancers
Primary liver cancer is the third most common cause of cancer-related deaths worldwide. Risk factors for primary liver cancer include chronic viral hepatitis B and C infections, alcohol abuse, non-alcoholic fatty liver disease, and obesity. Surgical resection and/or transplantation is the mainstay treatment for candidates with primary liver tumors. However, minimally invasive, image-guided locoregional therapies have become an integral part of liver cancer treatment and management, depending on staging.
  • 969
  • 28 Jul 2023
Topic Review
Irritable Bowel Syndrome and Artificial Intelligence
Irritable bowel syndrome (IBS) has a global prevalence of around 4.1% and is associated with a low quality of life and increased healthcare costs. Current guidelines recommend that IBS is diagnosed using the symptom-based Rome IV criteria. Despite this, when patients seek medical attention, they are usually over-investigated. This issue might be resolved by novel technologies in medicine, such as the use of Artificial Intelligence (AI). 
  • 969
  • 07 Nov 2023
Topic Review
Tumor Microenvironment in Hepatocellular Carcinoma
The interaction of the cellular environment surrounding the tumor plays a relevant role in hepatocellular carcinoma (HCC) pathogenesis. The tumor microenvironment is directly implicated in the modulation of liver fibrosis, the process of hepatocarcinogenesis, the epithelial-mesenchymal transition (EMT), invasion, and metastasis. Besides liver cancer cells, several cell types participate in the tumor progression in the liver. 
  • 966
  • 25 Feb 2022
Topic Review
Nutritional Support Techniques
Gastrointestinal cancers represent a major cause of morbidity and mortality worldwide. A significant issue regarding the therapeutic management of these patients consists of metabolic disturbances and malnutrition. Nutritional deficiencies have a negative impact on both the death rates of these patients and the results of surgical or oncological treatments. Thus, current guidelines recommend the inclusion of a nutritional profile in the therapeutic management of patients with gastrointestinal cancers. The development of digestive endoscopy techniques has led to the possibility of ensuring the enteral nutrition of cancer patients without oral feeding through minimally invasive techniques and the avoidance of surgeries, which involve more risks. The enteral nutrition modalities consist of endoscopy-guided nasoenteric tube (ENET), percutaneous endoscopic gastrostomy (PEG), percutaneous endoscopic gastrostomy with jejunal tube extension (PEG-J), direct percutaneous endoscopic jejunostomy (DPEJ) or endoscopic ultrasound (EUS)-guided gastroenterostomy.
  • 966
  • 15 Aug 2022
Topic Review
Effect of COVID-19 on Liver
The gastrointestinal tract plays an important role in the pathogenesis of COVID-19. Most patients present with gastrointestinal symptoms and/or abnormal liver function tests, both of which have been associated with adverse outcomes. The mechanisms of liver damage are currently under investigation, but the damage is usually transient and nonsevere. Liver transplantation is the only definitive treatment for acute liver failure and end-stage liver disease, and unfortunately, because of the need for ventilators during the COVID-19 pandemic, most liver transplant programs were temporarily suspended. 
  • 966
  • 26 Sep 2022
Topic Review
Diagnostic Methods in H. pylori Infection
Helicobacter pylori (H. pylori) develops potentially life-threatening conditions in adults if not appropriately treated. Helicobacter pylori is a common human pathogen that was first described in the stomach many years ago. 
  • 966
  • 11 Jan 2023
Topic Review
Genetics in Familial Intrahepatic Cholestasis
The family of inherited intrahepatic cholestasis includes autosomal recessive cholestatic rare diseases of childhood involved in bile acids secretion or bile transport defects. Specific genetic pathways potentially cause many otherwise unexplained cholestasis or hepatobiliary tumours in a healthy liver. Next-generation sequencing and whole-exome sequencing have improved the diagnostic procedures of familial intrahepatic cholestasis (FIC), as well as the discovery of several genes responsible for FIC.
  • 964
  • 24 Feb 2023
Topic Review
Cirrhotic Cardiomyopathy
Cirrhotic cardiomyopathy (CCM), cardiac dysfunction in end-stage liver disease in the absence of prior heart disease, is an important clinical entity that contributes significantly to morbidity and mortality. The original definition for CCM, established in 2005 at the World Congress of Gastroenterology (WCG), was based upon known echocardiographic parameters to identify subclinical cardiac dysfunction in the absence of overt structural abnormalities. Subsequent advances in cardiovascular imaging and in particular myocardial deformation imaging have rendered the WCG criteria outdated. A number of investigations have explored other factors relevant to CCM, including serum markers, electrocardiography, and magnetic resonance imaging. CCM characteristics include a hyperdynamic circulatory state, impaired contractility, altered diastolic relaxation, and electrophysiological abnormalities, particularly QT interval prolongation. It is now known that cardiac dysfunction worsens with the progression of cirrhosis. Treatment for CCM has traditionally been limited to supportive efforts, but new pharmacological studies appear promising. Left ventricular diastolic dysfunction in CCM can be improved by targeted heart rate reduction. Ivabradine combined with carvedilol improves left ventricular diastolic dysfunction through targeted heart rate reduction, and this regimen can improve survival in patients with cirrhosis. Orthotopic liver transplantation also appears to improve CCM. 
  • 962
  • 12 Oct 2021
Topic Review
Her-2 in Gastrointestinal Tumours
Gastrointestinal (GI) tumors account for a quarter of all the cancer burden and a third of the global cancer-related mortality. Among them, some cancers retain a dismal prognosis; therefore, newer and innovative therapies are urgently needed in priority disease areas of high-unmet medical need. In this context, HER2 could be a relevant prognostic and predictive biomarker acting as a target for specific drugs. However, if the role of HER2 has been object of investigation for several years in gastric cancer, it is not well established in other GI malignancies. The aim of this narrative review was to portray the current landscape of the potential role of HER2 as a predictive biomarker for GI tumors beyond gastric cancer. In colon cancer, the benefit from anti-HER2 therapies is less clear than in gastric neoplasms for the lack of controlled studies. Pancreatic, biliary tract adenocarcinomas and hepatocarcinoma may derive a less clear clinical benefit by using anti-HER2 agents in HER2 positive tumors. Overall, the results are promising and seem to suggest that the integration of multiple modalities of therapies can optimize the cancer care. However, further prospective trials are needed to validate the use of personalized targeted therapies in this field.
  • 961
  • 11 Jan 2021
Topic Review
Drug Targeting of IBD
Inflammatory bowel diseases (IBD) are disabling, noncommunicable, progressive and incurable immune-mediated inflammatory diseases (IMIDs). Crohn’s disease (CD) and ulcerative colitis (UC) constitute the most prevalent forms of IBD. These diseases are highly prevalent worldwide, particularly in Europe and North America, and are spreading globally at an accelerated rate.
  • 960
  • 18 Aug 2021
Topic Review
Gastroesophageal Reflux Disease
This entry describes the actual knowledge on diagnosis and management of extra-esophageal manifestations of gastro-esophageal reflux disease. The 2006 Montreal consensus defined GERD as a condition that develops when the reflux of the stomach contents causes troublesome symptoms and/or complications into the esophagus. Tissue damage related to GERD range from esophagitis to Barrett’s esophagus and esophageal adenocarcinoma; troublesome symptoms attributable to reflux can be esophageal (heartburn, regurgitation) or extra-esophageal (EE). GERD can be further classified by the presence of erosions on endoscopic examination (Erosive Reflux Disease [ERD] and Nonerosive Reflux Disease [NERD]).
  • 958
  • 23 Jun 2021
Topic Review
Sarcopenic Obesity
Sarcopenia was first termed in 1989 by Rosenberg et al. as a muscle loss in the aging population [19]. Although several definitions coexist, sarcopenia’s well-adopted description is an age-related process characterized by progressive loss of skeletal muscle mass and function.
  • 956
  • 18 Mar 2021
Topic Review
Crohn’s Disease and Intestinal Cancers
Crohn's Disease (CD) is a chronic, relapsing–remitting disease, which can affect the entire gastrointestinal tract with transmural inflammation. It is characterized by a progressive course with damage accumulation and onset of complications. CD patients have an increased risk of both intestinal and extra-intestinal cancers compared to the general population and chronic inflammation has been identified as the main risk factor for cancerization.
  • 956
  • 10 May 2021
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