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Topic Review
High-Quality Colonoscopy Components 1, 2 & 3
Colorectal cancer (CRC) continues to be the third leading cause of cancer-related deaths in the US. Colonoscopy remains the best preventative tool against the development of CRC. As a result, high-quality colonoscopy is becoming increasingly important.
  • 502
  • 09 Jun 2022
Topic Review
Enteric Glia and Its Modulation by Endocannabinoid System
The enteric nervous system (ENS) is a part of the autonomic nervous system that intrinsically innervates the gastrointestinal (GI) tract. Whereas enteric neurons have been deeply studied, the enteric glial cells (EGCs) have received less attention. However, these are immune-competent cells that contribute to the maintenance of the GI tract homeostasis through supporting epithelial integrity, providing neuroprotection, and influencing the GI motor function and sensation. The endogenous cannabinoid system (ECS) includes endogenous classical cannabinoids (anandamide, 2-arachidonoylglycerol), cannabinoid-like ligands (oleoylethanolamide (OEA) and palmitoylethanolamide (PEA)), enzymes involved in their metabolism (FAAH, MAGL, COX-2) and classical (CB1 and CB2) and non-classical (TRPV1, GPR55, PPAR) receptors. The ECS participates in many processes crucial for the proper functioning of the GI tract, in which the EGCs are involved.
  • 502
  • 01 Nov 2022
Topic Review
NAFLD Distribution
Non-alcoholic fatty liver disease (NAFLD) is considered the liver manifestation of metabolic syndrome. Nowadays, its prevalence is 25% worldwide and it is projected to reach the 30% in 2030, making NAFLD an important public health issue. NAFLD prevalence can vary according to the region and the social group under study. In fact, NAFLD distribution shows large inequalities by social group: Males have higher NAFLD prevalence, although if only postmenopausal women are taken into account, the prevalence is similar between genders. In the US, the Hispanic population has the highest NAFLD prevalence and African-American the lowest. Finally, higher NAFLD prevalence has been found among individuals with lower socioeconomic positions and food-insecure households. 
  • 499
  • 24 Nov 2021
Topic Review
Antibiotic Resistance in Helicobacter pylori
Despite the declining trend of Helicobacter pylori (H. pylori) prevalence around the globe, ongoing efforts are still needed to optimize current and future regimens in view of the increasing antibiotic resistance. The resistance of H. pylori to different antibiotics is caused by different molecular mechanisms, and advancements in sequencing technology have come a far way in broadening our understanding and in facilitating the testing of antibiotic susceptibility to H. pylori.
  • 499
  • 28 Jul 2023
Topic Review
Cognitive Dysfunction in NAFLD
Non-alcoholic fatty liver disease (NAFLD) has emerged as the hepatic component of the metabolic syndrome and now seemingly affects one-fourth of the world population. Several features associated with NAFLD have frequently been linked to cognitive dysfunction, i.e. systemic inflammation, impaired urea synthesis, vascular dysfunction, gut dysbiosis, and sleep apnoea. Considering the growing burden of NAFLD, the morbidity from cognitive dysfunction is expected to have huge societal and economic impact. Here, a review of the clinical evidence of cognitive dysfunction in NAFLD is provided.
  • 498
  • 04 Mar 2021
Topic Review
Epigenetics in Inflammatory Bowel Disease
Inflammatory bowel diseases (IBD) are chronic inflammatory disorders of the gastrointestinal tract that encompass two main phenotypes, namely Crohn’s disease and ulcerative colitis. These conditions occur in genetically predisposed individuals in response to environmental factors. Epigenetics, acting by DNA methylation, post-translational histones modifications or by non-coding RNAs, could explain how the exposome (or all environmental influences over the life course, from conception to death) could influence the gene expression to contribute to intestinal inflammation.
  • 498
  • 25 Jul 2022
Topic Review
Morphological Variations of the Liver
Radiologists and oncogynecologists should be familiar with different liver shape variations to avoid diagnostic errors and unwanted intraoperative surgical complications. Surgeons should be aware of variations in liver shape as in such cases, the vasculature or gallbladder may have a variant anatomical location.
  • 498
  • 16 Jan 2024
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.
  • 497
  • 16 Sep 2022
Topic Review
Microvascular Thrombosis and Liver Fibrosis Progression
Fibrosis is a frequent consequence of organ injury. The formation of an extracellular matrix (ECM) depends on a complex cascade of cellular and molecular pathways, the chronic activation of which results in a sustained fibrogenic process that leads to structural changes and, ultimately, to dysfunction of the affected organ. Thus, fibrosis is a major contributor to organ failure in human pathophysiology.
  • 496
  • 06 Jul 2023
Topic Review
Endoscopic Bariatric and Metabolic Therapies
Obesity is a chronic disease that is becoming increasingly more prevalent and is associated with many health problems, such as metabolic syndrome. The treatment options for obese patients include lifestyle modification, medications, endoscopic bariatric and metabolic therapies (EBMTs), and surgery. In particular, EBMTs have an excellent therapeutic effect and are less invasive than bariatric surgery.
  • 495
  • 10 Aug 2021
Topic Review
Genetic Alterations in Intraductal Papillary Mucinous Neoplasms
Intraductal papillary mucinous neoplasms (IPMN) are benign pancreatic cysts found in the ducts of the pancreas that have the potential to become malignant. Identifying IPMNs that have high potential to become pancreatic cancer may help prevent unnecessary surgery which is the definitive treatment of IPMNs. Whole exome and targeted sequencing were utilized to better characterize the genetic alterations in IPMNs. The most commonly mutated gene in IPMNs is KRAS with 50–80% of IPMNs harboring a KRAS mutation.
  • 495
  • 31 Mar 2023
Topic Review
Microbiota in Healthy Individuals
Although the microbiome is dynamic, changing in relation with human age and health status, there is an equilibrium between different types of species maintaining eubiosis and sustaining an absence of pathology. “All diseases begin in the gut” is an ancient quote that still maintains its truth: alteration of the composition and function of the healthy microbial structure leads to dysbiosis, resulting in various gastrointestinal (GI) disorders, systemic metabolic diseases, and neurological impairments.
  • 494
  • 14 Dec 2022
Topic Review
Use of Herbal Dietary Supplements in the USA
Herbal and dietary supplement (HDS) use has grown exponentially in the United States. Unfortunately, the incidence of HDS-related liver injury has proportionally increased. Despite the potential for certain HDSs to cause clinically significant liver injury, they are not regulated by the Food and Drug Administration. The efforts have been made to regulate HDSs but are far removed from the scrutiny of prescription medications. Scant literature exists on HDSs and their risks of causing liver injury.
  • 492
  • 19 Aug 2022
Topic Review
Endoscopic Stenting for Malignant Dysphagia with Esophageal Cancer
Malignant dysphagia is a common problem in patients with esophageal cancer. Endoscopic stenting can resolve dysphagia caused by malignant stricture; however, controversy exists regarding the use of esophageal stenting for the treatment of malignant stricture, including whether stenting or radiotherapy is superior, whether stenting before or after radiotherapy is safe, whether stenting before or after chemotherapy is safe, and whether low-radial-force stents are safer than conventional stents. 
  • 492
  • 27 Jun 2023
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.
  • 489
  • 28 Jul 2023
Topic Review
Microbiomes Influence the Effects of Diet on Cancer
Microbiomes interact with localized and systemic host cell populations where they help to maintain immune homeostasis. Microbiota use different dietary factors for energy and in turn produce by-products that impact the host cell populations. Dietary factors can also influence the composition and diversity of microbiota populations, in turn impacting the interactions of the microbiomes with host. Perturbations in this system, commonly referred to as dysbiosis, have been associated with various diseases including cancer.
  • 488
  • 09 Feb 2023
Topic Review
Epidemiology of Eosinophilic Esophagitis
Eosinophilic esophagitis is a Th-2 antigen-mediated disease in which there is an influx of eosinophils to all layers of the esophagus, triggering an inflammatory response. Chronic inflammatory process causes esophageal remodeling, leading to difficulties in swallowing. Food impaction, heartburn, and chest pain are other characteristic (but not pathognomonic) symptoms in adults.
  • 488
  • 13 Apr 2023
Topic Review
MicroRNAs in Ulcerative Colitis
Ulcerative colitis (UC) is a major type of inflammatory bowel disease (IBD), characterized by chronic inflammation of the colon and rectum. Inflammation confined to the mucosa is distributed continuously from the rectum to the proximal colon in UC and causes bloody stools, diarrhea, and abdominal pain.
  • 487
  • 20 Dec 2021
Topic Review
Galectin-1 in Pancreatic Ductal Adenocarcinoma
Galectin-1 is a unique and critical member of the galectin family, characterized by its ability to bind to β-galactoside-containing glycoconjugates. 
  • 487
  • 07 Nov 2023
Topic Review
Lenvatinib for Hepatocellular Carcinoma
Lenvatinib, which is an oral multikinase inhibitor, showed non-inferiority to the sorafenib in terms of overall survival (OS) and a higher objective response rate (ORR) and better progression-free survival (PFS) in patients with hepatocellular carcinoma (HCC). A good liver function and Barcelona Clinic Liver Cancer (BCLC) intermediate stage were key factors in achieving therapeutic efficacy. The management of adverse events plays an important role in continuing lenvatinib treatment. While sequential therapies contributed to prolonging overall survival, effective molecular targeted agents for administration after lenvatinib have not been established. Repeated transcatheter arterial chemoembolization (TACE) was associated with a decline in the liver function and poor therapeutic response in BCLC intermediate patients. Recently, the Asia-Pacific Primary Liver Cancer Expert (APPLE) Consensus Statement proposed the criteria for TACE unsuitability. Upfront systemic therapy may be better for BCLC intermediate stage HCC patients with a high tumor burden, while selective TACE will be recommended to obtain a curative response in patients with a low tumor burden. This entry introduce the therapeutic response, management of adverse events, post-progression treatment after lenvatinib and treatment strategy for BCLC intermediate stage HCC.
  • 486
  • 12 Oct 2021
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