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Topic Review
Transoral Outlet Reduction for Roux-en-Y Gastric Bypass
Obesity is a chronic relapsing disease of global pandemic proportions. In this context, an increasing number of patients are undergoing bariatric surgery, which is considered the most effective weight loss treatment for long-term improvement in obesity-related comorbidities. One of the most popular bariatric surgeries is the Roux-en-Y gastric bypass (RYGB).
  • 376
  • 15 Jun 2023
Topic Review
Pancreatic and Biliary Neoplasms
Pancreatic cancer and cholangiocarcinoma are aggressive diseases mostly diagnosed at an advanced and inoperable stage. 
  • 375
  • 27 Jan 2022
Topic Review
HER2 in Metastatic Colorectal Cancer
HER2 is an emerging biomarker in colorectal cancer (CRC). This oncogene plays an essential role in regulating cell proliferation, differentiation, migration, and, more in general, tumorigenesis and tumor progression. The most frequent types of HER2 alterations in CRC include gene amplification and missense mutations in 7–8% of CRC, often being mirrored by HER2 protein overexpression, representing founder events in solid tumors, including CRC.
  • 375
  • 09 Feb 2023
Topic Review
Herbal and Hepatocellular Cancer
Cirrhosis is the most important risk factor for the development of Hepatocellular cancer (HCC). Thus, it is estimated that one out of three patients with cirrhosis will suffer from HCC during their lifetime. Although chronic viral hepatitis, chronic alcohol intake and metabolic-associated fatty liver disease (MAFLD) are responsible for most cases of cirrhosis, any other cause of cirrhosis (such as herbal causes) might result in hepatocellular carcinoma.
  • 374
  • 24 Nov 2022
Topic Review
Metabolic-Dysfunction-Associated Steatotic Liver Disease
Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a chronic liver disease that affects more than a quarter of the global population and whose prevalence is increasing worldwide due to the pandemic of obesity. Obesity, impaired glucose metabolism, high blood pressure and atherogenic dyslipidemia are risk factors for MASLD.
  • 373
  • 01 Nov 2023
Topic Review
Role of Intestinal Microbiota in Pathogenesis of NAFLD
The term “gut microbiota” refers to the microorganism community residing in the intestinal lumen, while the term “gut microbiome” refers to the entire ecological habitat, including the microorganisms as well as their genomes and the surrounding environmental conditions. There has been a growing body of evidence linking the presence of intestinal dysbiosis to the pathogenesis of human liver disease, with a primary focus on metabolic diseases, including non-alcoholic fatty liver disease (NAFLD).
  • 372
  • 08 Aug 2022
Topic Review
Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome
Metabolic syndrome (MetS) is characterized by an association of cardiovascular and diabetes mellitus type 2 risk factors. Although the definition of MetS slightly differs depending on the society that described it, its central diagnostic criteria include impaired fasting glucose, low HDL-cholesterol, elevated triglycerides levels and high blood pressure. Insulin resistance (IR) is believed to be the main cause of MetS and is connected to the level of visceral or intra-abdominal adipose tissue, which could be assessed either by calculating body mass index or by measuring waist circumference. Studies revealed that IR may also be present in non-obese patients, and considered visceral adiposity to be the main effector of MetS’ pathology. Visceral adiposity is strongly linked with hepatic fatty infiltration also known as non-alcoholic fatty liver disease (NAFLD), therefore, the level of fatty acids in the hepatic parenchyma is indirectly linked with MetS, being both a cause and a consequence of this syndrome.
  • 372
  • 23 Feb 2023
Topic Review
Proteomics in Adult and Pediatric Inflammatory Bowel Diseases
Inflammatory bowel diseases (IBD) are systemic immune-mediated conditions with predilection for the gastrointestinal tract and include Crohn’s disease and ulcerative colitis. Genomic and transcriptomic studies contributed substantially to our understanding of the immunopathological pathways involved in disease initiation and progression. However, eventual genomic alterations do not necessarily translate into the final clinical picture. Proteomics represent a missing link between the genome, transcriptome, and phenotypical presentation of the disease. Based on the analysis of a large spectrum of proteins in tissues, it seems to be a promising method for the identification of new biomarkers.
  • 371
  • 12 Jun 2023
Topic Review
Janus Kinase Inhibitors for Inflammatory Bowel Disease
Janus kinase inhibitors are small-molecule drugs that can be administered orally and are relatively inexpensive, thus offering an additional option for treating Inflammatory bowel disease (IBD). They have been shown to be effective in patients with ulcerative colitis (UC), but they are less effective in those with Crohn’s disease (CD).
  • 370
  • 26 Oct 2021
Topic Review
Osteoporosis after Sleeve Gastrectomy and Roux-En-Y-gastric Bypass
Obesity has become a worldwide epidemic accompanied by adverse health effects. The limited efficiency of traditional weight reduction regimens has led to a substantial increase in the use of bariatric surgery. Sleeve gastrectomy (SG) and Roux-en-Y-gastric bypass (RYGB) are the most used procedures. Preoperatively, the dietary habits of obese individuals might lead to deficiencies in vitamin D and other nutrients affecting bone mineral metabolism. Bariatric surgery with SG or RYGB can aggravate these deficiencies. The various surgical procedures appear to affect nutrient absorption differently. Being purely restrictive, SG may particularly affect the absorption of vitamin B12 and also vitamin D. In contrast, RYGB has a more profound impact on the absorption of fat-soluble vitamins and other nutrients, although both surgical methods induce only a mild protein deficiency. Despite adequate supplementation of calcium and vitamin D, osteoporosis may still occur after the surgery. This might be due to deficiencies in other micronutrients, e.g., vitamin K and zinc. Regular follow-ups with individual assessments and nutritional advice are indispensable to prevent osteoporosis and other adverse postoperative issues.
  • 370
  • 21 Mar 2023
Topic Review
Management of Fibro-Stenosing Crohn’s Disease
Fibro-stenosing Crohn’s disease (CD) is a common disease presentation that leads to impaired quality of life and often requires endoscopic treatments or surgery. Managing the treatment of individuals with fibro-stenosing CD is challenging and requires a multidisciplinary team comprising a gastroenterologist, a colorectal surgeon, and a radiologist to evaluate the appropriate strategy. The optimal therapeutic approach changes according to the features of the stenosis (i.e., location, length, angulation), the presence of any associated complications (i.e., fistula, abscess, dysplasia), and the patient’s preference.
  • 370
  • 10 May 2023
Topic Review
Management of Radiation-Induced Esophageal Cancer
Radiation-induced esophageal cancer (RIEC) can arise in a previously irradiated field, mostly in patients previously irradiated for thoracic malignancies such as breast cancer, Hodgkin and non-Hodgkin lymphomas, head and neck cancers, lung cancer, or previous esophageal cancer. RIEC is rare and accounts for less than 1% of all carcinomas of the esophagus. RIEC seems to represent a biologically aggressive disease with a poor prognosis. Although it is difficult to perform radical surgery on a previously irradiated field, R0 resection remains the mainstay of treatment. The use of neoadjuvant and adjuvant chemoradiotherapy remains very helpful in RIEC, similarly to conventional esophageal cancer protocols.
  • 366
  • 01 Aug 2022
Topic Review
Nutritional Factors Benefit Postmenopausal Women with NAFLD
Nonalcoholic fatty liver disease (NAFLD) is a prevalent condition among postmenopausal women that can lead to severe liver dysfunction and increased mortality. There is also growing evidence that specific nutritional factors may help to prevent or treat NAFLD. For example, supplementation with vitamins C, D, and E may exert beneficial effects on liver health or related metabolic features, primarily through their antioxidant and anti-inflammatory properties. Coffee consumption is inversely associated with a number of liver-related conditions, including slower progression of fibrosis, lower transaminase levels, and decreased liver-related mortality, and some of these positive effects may be due to caffeine. Caffeine has also been shown to improve features of metabolic syndrome, including hepatic injury in high carbohydrate, high-fat-diet-fed rat; increase energy expenditure; and reduce total body, trunk, and visceral fat or fat mass. 
  • 365
  • 21 Jun 2023
Topic Review
Role of Methionine Restriction in Gastric Cancer
Gastric cancer is ranked as the fifth most prevalent cancer globally and has long been a topic of passionate discussion among numerous individuals. However, the incidence of gastric cancer in society has not decreased, but instead has shown a gradual increase in recent years. For more than a decade, the treatment effect of gastric cancer has not been significantly improved. This is attributed to the heterogeneity of cancer, which makes popular targeted therapies ineffective. Methionine is an essential amino acid, and many studies have shown that it is involved in the development of gastric cancer. Our study aimed to review the literature on methionine and gastric cancer, describing its mechanism of action to show that tumor heterogeneity in gastric cancer does not hinder the effectiveness of methionine-restricted therapies. This research also aimed to provide insight into the inhibition of gastric cancer through metabolic reprogramming with methionine-restricted therapies, thereby demonstrating their potential as adjuvant treatments for gastric cancer.
  • 364
  • 18 Mar 2024
Topic Review
Endoscopic and Surgical Management of Stricturing Crohn’s Disease
Crohn’s disease (CD) is a systemic disease, primarily affecting the gastro-intestinal tract, of which the etiology has not been clarified. Genetic and environmental factors are indicated to contribute to CD development. CD may affect any part of the digestive tract, whereas disease behavior may change over time and progress to fibrostenotic and penetrating disease. It is estimated that approximately 40% of CD patients will develop naïve symptomatic strictures (e.g., intestinal obstruction), whereas it is not uncommon for the development of anastomotic strictures. Diagnosis <40 years of age, need for steroids at diagnosis, small bowel involvement, and smoking has been associated with stricturing CD. Symptoms of stricturing CD may include nausea, vomiting, abdominal cramping, and abdominal flatulence, leading to decreased quality of life.
  • 362
  • 06 May 2022
Topic Review
Primary Sclerosing Cholangitis-Associated Cholangiocarcinoma
Cholangiocarcinoma (CCA) is the most common malignancy in patients with primary sclerosing cholangitis (PSC), accounting for 2–8% of cases and being the leading cause of death in these patients. The majority of PSC-associated CCAs (PSC-CCA) develop within the first few years after PSC diagnosis. Older age and male sex, as well as concomitant inflammatory bowel disease (IBD) or high-grade biliary stenosis, are some of the most relevant risk factors. PSC-CCA pathogenesis is characterised by peculiar molecular and genetic features, being a distinct disease from the novo CCA. There has been a significant push to develop innovative strategies for PSC-CCA early diagnosis and surveillance. 
  • 361
  • 23 Oct 2023
Topic Review
γδ T Cells in Hepatocellular Carcinoma Immunotherapy
Hepatocellular carcinoma (HCC) remains a global health challenge with limited treatment options and a poor prognosis for advanced-stage patients. Recent advancements in cancer immunotherapy have generated significant interest in exploring novel approaches to combat HCC. One such approach involves the unique and versatile subset of T cells known as γδ T cells. γδ T cells represent a distinct subset of T lymphocytes that differ from conventional αβ T cells in terms of antigen recognition and effector functions. They play a crucial role in immunosurveillance against various malignancies, including HCC.
  • 359
  • 30 Jan 2024
Topic Review
Role of Antioxidants  in Inflammatory Bowel Disease
Oxidative stress (OS) is defined as an imbalance between the induction of reactive oxygen species (ROS) and the antioxidant components of the body’s defence system. ROS are molecules composed of at least one oxygen atom and containing at least one unpaired electron. From a biochemical perspective, ROS are highly reactive compounds that interact reactively with cell organelles. ROS include hydrogen peroxide (H2O2), superoxide radicals (O2•−), hydroxyl radicals (•OH), and singlet oxygen (O2). They are mainly produced as by-products of oxygen metabolism processes, but there are external triggers that contribute to their increase.
  • 358
  • 26 May 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.
  • 358
  • 29 Dec 2023
Topic Review
Gastrointestinal Microbiome in Liver Disease
Liver disease is a major global health problem leading to approximately two million deaths a year. This is the consequence of a number of aetiologies, including alcohol-related, metabolic-related, viral infection, cholestatic and immune disease, leading to fibrosis and, eventually, cirrhosis. No specific registered antifibrotic therapies exist to reverse liver injury, so treatment aims at managing the underlying factors to mitigate the development of liver disease. There are bidirectional feedback loops between the liver and the rest of the gastrointestinal tract via the portal venous and biliary systems, which are mediated by microbial metabolites, specifically short-chain fatty acids (SCFAs) and secondary bile acids.
  • 356
  • 14 Sep 2023
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