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Topic Review
Surgical Strategies for Recurrent Hepatocellular Carcinoma after Resection
Among primary liver cancers, hepatocellular carcinoma (HCC) is the most common. Surgical resection and liver transplantation both represent potentially curative treatments not only in the case of the first occurrence, but also in those cases of disease recurrence if a proper selection of patients is performed ahead. Incidentally, the type and the time of relapse carry important weight on patient prognosis and overall survival. For these cases, proper management has still not been exactly defined.
  • 881
  • 11 Feb 2023
Topic Review
PD-L1 Expression as a Biomarker in Gastric Cancer
Despite advances in diagnostic imaging, surgical techniques, and systemic therapy, gastric cancer (GC) is the third leading cause of cancer-related death worldwide. Unfortunately, molecular heterogeneity and, consequently, acquired resistance in GC are the major causes of failure in the development of biomarker-guided targeted therapies. However, by showing promising survival benefits in some studies, the recent emergence of immunotherapy in GC has had a significant impact on treatment-selectable procedures. Immune checkpoint inhibitors (ICIs), widely indicated in the treatment of several malignancies, target inhibitory receptors on T lymphocytes, including the programmed cell death protein (PD-1)/programmed death-ligand 1 (PD-L1) axis and cytotoxic T-lymphocyte-associated protein 4 (CTLA4), and release effector T-cells from negative feedback signals. 
  • 881
  • 26 Sep 2023
Topic Review
Heterogeneity Sources in Metabolic Dysfunction-Associated Fatty Liver Disease
Non-alcoholic fatty liver disease (NAFLD) is a slowly progressing disease, beginning with isolated liver steatosis that evolves in a subset of patients to non-alcoholic steatohepatitis (NASH), liver fibrosis, cirrhosis and hepatocellular carcinoma (HCC). It was recently proposed to redefine NAFLD to metabolic dysfunction-associated fatty liver disease (MAFLD) in which other known causes of liver disease such as alcohol consumption or viral hepatitis do not need to be excluded. Revised nomenclature envisions speeding up and facilitating anti-MAFLD drug development by means of patient stratification whereby each subgroup would benefit from distinct pharmacological interventions. 
  • 879
  • 24 Jan 2022
Topic Review
Intestinal Tryptophan Metabolism in Inflammatory Bowel Disease
Evidence is emerging for the role of intestinal tryptophan metabolism in the development of inflammatory bowel disease (IBD). In order to identify the role of altered intestinal tryptophan metabolism in IBD pathogenesis, a meta-analysis of the transcriptome was performed to identify differentially expressed genes involved in the tryptophan metabolism pathways in intestinal biopsies of IBD as compared to non-IBD controls.
  • 879
  • 18 Jul 2023
Topic Review
Inflammation in COVID-19
SARS-CoV-2 is an enveloped and positive-sense single stranded RNA (+ssRNA) virus. It belongs to the betacoronavirus family, one of the four groups of the coronoviridae, which also includes two highly pathogenic viruses, Severe Acute Respiratory Syndrome Human Coronavirus (SARS-CoV) and the Middle Eastern Respiratory Syndrome Coronavirus (MERS-Cov).
  • 877
  • 28 Nov 2022
Topic Review
Single-Cell RNA Sequencing for Crohn’s Disease Fibrosis Mechanisms
Crohn’s disease (CD) is a chronic inflammatory bowel disease with a high prevalence throughout the world. The development of Crohn’s-related fibrosis, which leads to strictures in the gastrointestinal tract, presents a particular challenge and is associated with significant morbidity. There are no specific anti-fibrotic therapies available, and so treatment is aimed at managing the stricturing complications of fibrosis once it is established. This often requires invasive and repeated endoscopic or surgical intervention. 
  • 877
  • 25 Jun 2023
Topic Review
Gastric Mucosal Atrophy for Predicting Gastric Cancer Risk
Patients suffering from chronic gastritis and developing gastric mucosa atrophy are at increased risk of the development of gastric cancer. The diagnosis of chronic atrophic gastritis (CAG) is a complex procedure involving a detailed history taking, a thorough physical examination and the use of laboratory and instrumental diagnostic methods among which the endoscopy of the upper digestive tract is the cornerstone because it allows the assessment of the topography of gastritis and identification of erosions and areas of intestinal metaplasia with the use of narrow band imaging (NBI) endoscopy. However, the diagnosis of CAG requires morphological examination of the gastric mucosa.
  • 876
  • 26 Oct 2023
Topic Review
Secondary Primary Cancer after Primary Gastric Cancer
Advances in cancer screening and early detection, as well as improvements in surgical techniques and therapeutics, have contributed to decreasing gastric cancer mortality. The number of gastric cancer survivors continues to rise; however, long-term follow-up has revealed an increase in the risk of post-gastrectomy symptoms or other health problems, such as extra-gastric secondary primary cancer (SPC), in these survivors. The characteristics of SPC are of increasing interest to both treatment providers and gastric cancer survivors.
  • 874
  • 13 Jan 2023
Topic Review
Hirschsprung-Associated Enterocolitis
Despite the significant progress that has been made in terms of understanding the pathophysiology and risk factors of Hirschsprung-associated enterocolitis (HAEC), the morbidity rate has remained unsatisfactorily stable, and clinical management of the condition continues to be challenging.
  • 871
  • 04 May 2023
Topic Review
Inflammatory Bowel Disease Nurse
Patients affected by inflammatory bowel diseases (IBDs) are complex patients with various problems from a clinical and psychological point of view. This complexity must be addressed by a multidisciplinary team, and an inflammatory bowel disease nurse can be the ideal professional figure to create a link between doctor and patient. 
  • 870
  • 26 Apr 2021
Topic Review
Reevaluating Therapeutic Use of Antibiotics in Liver Cirrhosis
Impairments in liver function lead to different complications. As chronic liver disease progresses (CLD), hypoalbuminemia and alterations in bile acid compositions lead to changes in gut microbiota and, therefore, in the host–microbiome interaction, leading to a proinflammatory state. Alterations in gut microbiota composition and permeability, known as gut dysbiosis, have important implications in CLD; alterations in the gut–liver axis are a consequence of liver disease, but also a cause of CLD. Furthermore, gut dysbiosis plays an important role in the progression of liver cirrhosis and decompensation, particularly with complications such as hepatic encephalopathy and spontaneous bacterial peritonitis.
  • 870
  • 26 Sep 2023
Topic Review
Diagnosis of Early Gastrointestinal Neoplasia
Meticulous endoscopic characterization of gastrointestinal neoplasias (GN) is crucial to the clinical outcome. Hereby the indication and type of resection (endoscopically, en-bloc or piece-meal, or surgical resection) are determined. By means of established image-enhanced (IEE) and magnification endoscopy (ME) GN can be characterized in terms of malignancy and invasion depth. In this context, the statistical evidence and accuracy of these diagnostic procedures should be elucidated. Here, we present a systematic review of the literature. Results: 21 Studies could be found which met the inclusion criteria. In clinical prospective trials and meta-analyses, the diagnostic accuracy of >90% for characterization of malignant neoplasms could be documented, if ME with IEE was used in squamous cell esophageal cancer, stomach, or colonic GN. Conclusions: Currently, by means of optical diagnosis, today’s gastrointestinal endoscopy is capable of determining the histological subtype, exact lateral spread, and depth of invasion of a lesion. The prerequisites for this are an exact knowledge of the anatomical structures, the endoscopic classifications based on them, and a systematic learning process, which can be supported by training courses. More prospective clinical studies are required, especially in the field of Barrett’s esophagus and duodenal neoplasia.
  • 867
  • 13 Jul 2021
Topic Review
Pre-biotics, Probiotics and Post-Biotics
Gut microbiota (GM) is a complex ecosystem containing bacteria, viruses, fungi, and yeasts. It has several functions in the human body ranging from immunomodulation to metabolic. GM derangement is called dysbiosis and is involved in several host diseases. Pre-, probiotics, and symbiotics (PRE-PRO-SYMB) have been extensively developed and studied for GM re-modulation.
  • 867
  • 11 Jan 2022
Topic Review
Skeletal Muscles in Obesity
Skeletal muscles, as well as adipose tissue, are largely recognized as endocrine organs, producing biologically active substances, such as myokines and adipokines. They may have either beneficial or harmful effects on the organism and its functions, acting through the endocrine, paracrine, and autocrine pathways. Moreover, the collocation of adipose tissue and skeletal muscles, i.e., the amount of intramuscular, intermuscular, and visceral adipose depots, may be of major importance for metabolic health. Traditionally, the generalized and progressive loss of skeletal muscle mass and strength or physical function, named sarcopenia, has been thought to be associated with age.
  • 867
  • 05 Jul 2023
Topic Review
Occult Infection with Hepatitis C Virus
Occult infection with hepatitis C virus (OCI) is defined as the presence of HCV-RNA in hepatocytes, and/or PBMCs in individuals, who are HCV-RNA negative in serum by conventional diagnostic tests (with LoD 15 IU/mL). Depending on the presence or absence of anti-HCV in serum, two types of OCI are distinguished—seronegative and seropositive. Occult viral persistence by definition escapes clinical diagnostic schemes and can last for many years after spontaneous or treatment-induced sustained virological response (SVR).
  • 864
  • 29 Dec 2021
Topic Review
Adipokines in Non-Alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease (NAFLD) has become the major cause of chronic hepatic illness and the leading indication for liver transplantation in the future decades. NAFLD is also commonly associated with other high-incident non-communicable diseases, such as cardiovascular complications, type 2 diabetes, and chronic kidney disease. Aggravating the socio-economic impact of this complex pathology, routinely feasible diagnostic methodologies and effective drugs for NAFLD management are unavailable. The pathophysiology of NAFLD, defined as metabolic associated fatty liver disease (MAFLD), is correlated with abnormal adipose tissue–liver axis communication because obesity-associated white adipose tissue (WAT) inflammation and metabolic dysfunction prompt hepatic insulin resistance (IR), lipid accumulation (steatosis), non-alcoholic steatohepatitis (NASH), and fibrosis. Accumulating evidence links adipokines, cytokine-like hormones secreted by adipose tissue that have immunometabolic activity, with NAFLD pathogenesis and progression.
  • 864
  • 16 Sep 2022
Topic Review
Computer-Aided Detection False Positives
Defining FPs based on the duration of time is an objective way of classifying FPs. However, the threshold required for reporting FPs is unsettled. One report suggested that only FPs > 2 s be reported, and another only reported FPs > 1 s, while the majority of FPs (i.e., more than 90%) lasted <0.5 s. It is unknown whether ignoring the transient FPs (i.e., those lasting for <1 or 2 s) would increase the risk of missing a real polyp.
  • 863
  • 28 Jun 2021
Topic Review
Liver Transplantation versus Liver Resection
For patients with early-stage hepatocellular carcinoma, it is important to know whether liver transplantation offers a survival benefit over liver resection. Patients receiving transplantation often have different characteristics in terms of their cancer stage and liver function compared to those being resected. This makes a comparison of the two treatment modalities challenging. This article presents a critical appraisal of the currently available literature. We not only provide a summary of the main results of individual articles but also describe their strengths and weaknesses, the relationships among them, and their trends. As a result, we suggest the regression discontinuity design for future studies that uses thresholds of a treatment guideline to help ensure that the groups are more comparable. 
  • 862
  • 29 Mar 2022
Topic Review
EEN in Pre-Operative Optimisation in Crohn’s Disease
Crohn’s disease (CD) is a chronic inflammatory disease of the gastrointestinal tract, with increasing incidence worldwide. Exclusive enteral nutrition is the term used when a patient replaces their habitual diet with an exclusive liquid diet for a defined period. In clinical practice, the most frequent form of exclusive enteral nutrition (EEN) used is polymeric liquid feeds, for example, Fortisip™, Ensure™, or Modulen™. EEN is used extensively in the paediatric population to induce remission, but is not routinely used in the induction of remission of adult Crohn’s disease or in pre-operative optimisation.
  • 862
  • 17 Jun 2022
Topic Review
MRE Parameters That Correlate with Disease Activity
Crohn’s disease (CD) is a chronic immune mediated disorder that most commonly affects the small bowel and/or the large bowel. Treatment targets in CD include mucosal healing assessed via ileocolonoscopy and transmural healing assessed through cross-sectional imaging modalities such as magnetic resonance enterography (MRE).
  • 860
  • 20 Mar 2023
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