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Topic Review
Diagnosis of Post- Endoscopic Retrograde Cholangiopancreatography Pancreatitis
Endoscopic retrograde cholangiopancreatography (ERCP) is the primary therapeutic approach for disorders affecting the pancreatobiliary tree. It carries the highest risk of complications and mortality among other endoscopic modalities, with post-ERCP pancreatitis (PEP) being the most frequent complication, even after a seemingly straightforward procedure. Its incidence lies between 2–10%, which could be as high as 30–50% in high-risk cases. PEP is severe in up to 5% of cases, with potential for life-threatening complications, and death in up to 1% of cases. The risk of PEP is potentially predictable and may be modified with pharmacological measures and endoscopic techniques, also patient selection plays an important role.  The therapy for PEP is like that of acute pancreatitis. Analgesia and supportive care with moderate fluid therapy are often sufficient in most patients. In conclusion, PEP is a potentially life-threatening complication of ERCP which can be mitigated through a correct patient selection, combination of pharmacological and intraprocedural measures as well as prompt diagnosis and early management.
  • 594
  • 20 Oct 2022
Topic Review
Pancreatic and Biliary Neoplasms
Pancreatic cancer and cholangiocarcinoma are aggressive diseases mostly diagnosed at an advanced and inoperable stage. 
  • 593
  • 27 Jan 2022
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.
  • 593
  • 12 Jun 2023
Topic Review
Potential Therapeutic Strategies of Metabolic-Associated Fatty Liver Disease
Metabolic-associated Fatty Liver Disease is one of the outstanding challenges in gastroenterology. The increasing incidence of the disease is undoubtedly connected with the ongoing obesity pandemic. The lack of specific symptoms in the early phases and the grave complications of the disease require an active approach to prompt diagnosis and treatment. Therapeutic lifestyle changes should be introduced in a great majority of patients; but, in many cases, the adherence is not satisfactory. There is a great need for an effective pharmacological therapy for Metabolic-Associated Fatty Liver Disease, especially before the onset of steatohepatitis.
  • 591
  • 12 Nov 2023
Topic Review
Hepatobiliary Impairments in Patients with Inflammatory Bowel Diseases
Inflammatory bowel disease (IBD) refers to chronic conditions with a low mortality but high disability. The multisystemic nature of these diseases can explain the appearance of some extraintestinal manifestations, including liver damage. Abnormal liver biochemical tests can be identified in approximately one third of patients with IBD and chronic liver disease in 5% of them. Among the liver diseases associated with IBD are primary sclerosing cholangitis, cholelithiasis, fatty liver disease, hepatic amyloidosis, granulomatous hepatitis, drug-induced liver injury, venous thromboembolism, primary biliary cholangitis, IgG4-related cholangiopathy, autoimmune hepatitis, liver abscesses or the reactivation of viral hepatitis. The most common disease is primary sclerosing cholangitis, a condition diagnosed especially in patients with ulcerative colitis.
  • 590
  • 12 Jan 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.
  • 586
  • 01 Aug 2022
Topic Review
An Introduction to Liver Cancers
The liver is the largest and most functionally diverse organ in the human body, and is known to be a critical hub for multiple physiological processes. It is highly vascularized in its nature, making it the most common site for cancer development, especially metastatic cancers. 
  • 586
  • 06 Jan 2023
Topic Review
Contrast-Enhanced Endoscopic Ultrasonography
Endoscopic ultrasound can be useful for obtaining detailed diagnostic images for pancreatic disease. Contrast-enhanced harmonic endoscopic ultrasound has allowed to demonstrate not only microvasculature but also real perfusion imaging using second-generation contrast agents. Furthermore, endoscopic ultrasound fine-needle aspiration cytology and histology have become more ubiquitous.
  • 585
  • 27 Jun 2022
Topic Review
Gastric Cancer Due to Chronic H. pylori Infection
Helicobacter pylori is an established cause of many gastrointestinal pathologies including peptic ulcer disease, gastritis, and gastric cancer. It is an entity that affects the global population, and its true nature has only been known since the 1980s. Although there is much known about H. pylori including its pathophysiology, detection, and eradication, resistance to therapy models is common. This is problematic because untreated or inadequately treated H. pylori increases morbidity and mortality related to gastric cancer and peptic ulcer disease among others. In order to improve the treatment and reduce resistance, there is significant ongoing research identifying new detection and eradication methods for H. pylori.
  • 585
  • 02 Sep 2022
Topic Review
Hepatocellular Carcinoma Prevention
The hepatitis C virus (HCV), a single-stranded RNA virus belonging to the Flaviviridae family, is a major cause of hepatocellular carcinoma (HCC) worldwide. Tumors caused by HCC have an increased mortality rate globally, which is more accentuated in Western countries. The carcinogenic potential of this virus is mediated through a wide range of mechanisms, spanning from the induction of chronic inflammation to oxidative stress and deregulation of cellular pathways by viral proteins.
  • 581
  • 07 Oct 2023
Topic Review
Management of Inflammatory Bowel Disease and Colorectal Cancer
Patients with inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn’s disease, have an increased risk of developing colorectal cancer (CRC). Although advancements in endoscopic imaging techniques, integrated surveillance programs, and improved medical therapies have contributed to a decreased incidence of CRC in patients with IBD, the rate of CRC remains higher in patients with IBD than in individuals without chronic colitis. Patients with IBD-related CRCs exhibit a poorer prognosis than those with sporadic CRCs, owing to their aggressive histological characteristics and lower curative resection rate. 
  • 579
  • 31 Aug 2023
Topic Review
Dysbiosis in Gut Microbiotas
Dysbiosis refers to a disruption of the symbiotic relationship between the microbiota and the host, and it can contribute to various chronic diseases both within and outside the gut. These diseases include obesity, inflammatory bowel disease, diabetes mellitus, metabolic syndrome, atherosclerosis, chronic liver disease, neurological disorders, and cancer. Several factors can influence the composition of the microbiota and increase the risk of dysbiosis. These factors include diet, environmental factors, stress, aging, genetic factors, and broad-spectrum antibiotic use. 
  • 577
  • 05 Mar 2024
Topic Review
Inflammatory Biomarkers in Paediatric Inflammatory Bowel Diseases
Inflammatory bowel disease (IBD) is a distinct chronic, idiopathic, and relapsing disorder classified into two major conditions, including Crohn’s disease (CD) and ulcerative colitis (UC), which cause inflammation in the gastrointestinal tract (GIT). Short-chain fatty acids (SCFAs) produced by anaerobic bacterial fermentation of indigestible dietary fibre in the gut have potential value for their underlying epigenetic role in the treatment of obesity and asthma-related inflammation through mediating the relationships between VLCKD and the infant gut microbiota. 
  • 576
  • 21 Oct 2022
Topic Review
Mycobacterium avium ssp. paratuberculosis and Crohn’s Disease
Mycobacterium avium ssp. paratuberculosis (MAP) is the cause of Johne’s disease (JD), which is a chronic infectious gastrointestinal disease of ruminants and is often fatal. In humans, MAP has been associated with Crohn’s disease (CD) for over a century, without conclusive evidence of pathogenicity. Numerous researchers have contributed to the subject, but there is still a need for evidence of the causation of CD by MAP.
  • 576
  • 07 Mar 2024
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).
  • 575
  • 26 Oct 2021
Topic Review
Features of Liver Injury in COVID-19 Clinical Particularities
COVID-19 clinical presentation falls on a wide spectrum, from mild cases complaining of minor symptoms to severe illness with multiorgan dysfunctions and death. Multiple organ injuries have been described in COVID-19, such as pulmonary affliction, acute kidney damage, liver injury, stroke, cardiovascular and digestive tract disorders. 
  • 574
  • 07 Apr 2023
Topic Review
Sleep among Patients with Chronic Liver Disease
Sleep disturbances are commonly encountered among patients with CLDs and are associated with impaired HRQOL. The present study demonstrated that the more severe the liver disease, the poorer that sleep and QOL are. 
  • 571
  • 09 Jan 2022
Topic Review
Essential Factors Involved in Inflammatory Bowel Disease
Inflammatory bowel diseases (IBD) are without cure and troublesome to manage because of the considerable diversity between patients and the lack of reliable biomarkers. Diet, gut microbiota, genetics and other patient factors are essential for disease occurrence and progression. The gut epithelial barrier separates the luminal contents from the underlying tissue layers and immune cells. It controls the interactions between the patient’s immune system, the gut microbiota and environmental factors such as food components and is implicated in IBD.
  • 571
  • 18 Jul 2023
Topic Review
COVID-19 in Patients with Chronic Liver Disease
The liver is a secondary and often collateral target of COVID-19 disease but can lead to important consequences. COVID-19 might directly cause a high number of complications in patients with pre-existing chronic liver disease, increasing their risk of hepatic decompensation. Moreover, it also determines indirect consequences in the management of patients with liver disease, especially in those suffering from decompensated cirrhosis and HCC, as well as in the execution of their follow-up and the availability of all therapeutic possibilities. Liver imaging in COVID-19 patients proved to be highly nonspecific, but it can still be useful for identifying the complications that derive from the infection.
  • 570
  • 27 Mar 2023
Topic Review
Relevance of Fish Oil in Gastrointestinal-Cancer-Associated Cachexia
Fish oil is rich in omega-3 fatty acids, which aid in energy metabolism and utilizing fatty acids high in energy density. It has been shown to reduce levels of pro-inflammatory mediators because fish oil contains high amounts of omega-3 fatty acids, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and other polyunsaturated fatty acids (PUFAs). In a study of GI cancer patients undergoing surgical intervention, adding fish oil to arginine improved post-surgical outcomes and shortened recovery compared to no nutritional support in 305 patients.
  • 570
  • 07 Aug 2023
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