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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.
  • 903
  • 05 Jul 2023
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.
  • 902
  • 17 Jun 2022
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.
  • 902
  • 11 Feb 2023
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.
  • 901
  • 16 Sep 2022
Topic Review
Quorum Sensing in the Gut
An imbalance in gut microbiota, termed dysbiosis, has been shown to affect host health. Several factors, including dietary changes, have been reported to cause dysbiosis with its associated pathologies that include inflammatory bowel disease, cancer, obesity, depression, and autism. Quorum sensing (QS) is a complex network of cell–cell communication that is mediated by small diffusible molecules known as autoinducers (AIs). Using AIs, bacteria interact with one another and coordinate their gene expression based on their population density for the benefit of the whole community or one group over another. Bacteria that cannot synthesize their own AIs secretly “listen” to the signals produced by other bacteria, a phenomenon known as “eavesdropping”. AIs impact gut microbiota equilibrium by mediating intra- and interspecies interactions as well as interkingdom communication.
  • 901
  • 27 Feb 2023
Topic Review
Gastrointestinal Problems in COVID-19 Patients
The gastrointestinal tract is the body’s largest interface between the host and the external environment. People infected with SARS-CoV-2 are at higher risk of microbiome alterations and severe diseases. Recent evidence has suggested that the pathophysiological and molecular mechanisms associated with gastrointestinal complicity in SARS-CoV-2 infection could be explained by the role of angiotensin-converting enzyme-2 (ACE2) cell receptors.
  • 900
  • 05 Nov 2021
Topic Review
Fecal Microbiota Transplantation in the Management of Cancer
In a mutually beneficial connection with its host, the gut microbiota affects the host’s nutrition, immunity, and metabolism. An increasing number of studies have shown links between certain types of disease and gut dysbiosis or specific microorganisms. Fecal microbiota transplantation (FMT) is strongly advised for the treatment of recurrent or resistant Clostridium difficile infection (CDI) due to its outstanding clinical effectiveness against CDI. The therapeutic potential of FMT for other disorders, particularly inflammatory bowel diseases and malignancies, is currently gaining more and more attention. 
  • 900
  • 30 May 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. 
  • 899
  • 24 Jan 2022
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. 
  • 899
  • 26 Sep 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.
  • 898
  • 04 May 2023
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).
  • 896
  • 20 Mar 2023
Topic Review
Lipid Metabolism in Metabolic-Associated Steatotic Liver Disease
Metabolic-associated steatotic liver disease (MASLD) is a cluster of pathological conditions primarily developed due to the accumulation of ectopic fat in the hepatocytes. During the severe form of the disease, i.e., metabolic-associated steatohepatitis (MASH), accumulated lipids promote lipotoxicity, resulting in cellular inflammation, oxidative stress, and hepatocellular ballooning. If left untreated, the advanced form of the disease progresses to fibrosis of the tissue, resulting in irreversible hepatic cirrhosis or the development of hepatocellular carcinoma. Although numerous mechanisms have been identified as significant contributors to the development and advancement of MASLD, altered lipid metabolism continues to stand out as a major factor contributing to the disease.
  • 895
  • 29 Dec 2023
Topic Review
Therapeutic Approaches for Gastric Neuroendocrine Neoplasms
Gastric neuroendocrine neoplasms (gNENs) represent rare but increasingly recognized tumors. They are distinguished into three main clinical types (type-1, type-2, and type-3) according to gastrin level and at histological evaluation in well-differentiated G1, G2, or G3 lesions, as well as poorly-differentiated lesions.
  • 894
  • 13 Oct 2023
Topic Review
Non-Invasive Biomarkers for Immunotherapy with Hepatocellular Carcinoma
Tumor biomarkers are cellular and molecular products linked directly or indirectly to the presence of cancer cells that are an expression of the tumor’s intrinsic characteristics and can be identified, measured, and analyzed by specific tests.  Currently, there is an increasing interest in developing novel techniques to extract information on tumor biology directly from patient’s body fluids in a non-invasive way. Liquid biopsy, a non-invasive approach of tumor biomarkers detection, permits a dynamic picture of HCC’s evolution and response to therapy. 
  • 892
  • 20 Oct 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. 
  • 892
  • 25 Jun 2023
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.
  • 892
  • 26 Sep 2023
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. 
  • 891
  • 24 Nov 2021
Topic Review
Viral Liver Disease and Intestinal Gut–Liver Axis
The intestinal microbiota is closely related to liver diseases via the intestinal barrier and bile secretion to the gut. Impairment of the barrier can translocate microbes or their components to the liver where they can contribute to liver damage and fibrosis.
  • 890
  • 26 Jan 2024
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.
  • 887
  • 26 Oct 2023
Topic Review
Targeting Gut in Obesity: Signals from Inner Surface
Obesity is caused by prolonged energy surplus. Current anti-obesity medications are mostly centralized around the energy input part of the energy balance equation by increasing satiety and reducing appetite. Our gastrointestinal tract is a key organ for regulation of food intake and supplies a tremendous number of circulating signals that modulate the activity of appetite-regulating areas of the brain by either direct interaction or through the vagus nerve. Intestinally derived messengers are manifold and include absorbed nutrients, microbial metabolites, gut hormones and other enterokines, collectively comprising a fine-tuned signalling system to the brain. After a meal, nutrients directly interact with appetite-inhibiting areas of the brain and induce satiety. However, overall feeding behaviour also depends on secretion of gut hormones produced by highly specialized and sensitive enteroendocrine cells. Moreover, circulating microbial metabolites and their interactions with enteroendocrine cells further contribute to the regulation of feeding patterns. Current therapies exploiting the appetite-regulating properties of the gut are based on chemically modified versions of the gut hormone, glucagon-like peptide-1 (GLP-1) or on inhibitors of the primary GLP-1 inactivating enzyme, dipeptidyl peptidase-4 (DPP-4). The effectiveness of these approaches shows that that the gut is a promising target for therapeutic interventions to achieve significant weigh loss. 
  • 886
  • 24 Jan 2022
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