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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.
  • 569
  • 24 Nov 2022
Topic Review
Pathophysiological Mechanisms of Metabolic-Associated Liver Disease
Metabolic-associated liver disease (MAFLD) affects up to 70% of overweight and more than 90% of morbidly obese people, and its pathogenesis is rather complex and multifactorial. The criteria for MAFLD include the presence of hepatic steatosis in addition to one of the following three criteria: overweight or obesity, presence of type 2 diabetes mellitus (T2DM), or evidence of metabolic dysregulation. If the specific criteria are present, the diagnosis of MAFLD can be made regardless of alcohol consumption and previous liver disease. The pathophysiological mechanisms of MAFLD, including inflammation, lipotoxicity, mitochondrial disfunction, and oxidative stress, as well as the impact of intestinal gut microbiota, are constantly being elucidated. 
  • 567
  • 19 Jan 2024
Topic Review
Pathophysiology of Extra-Intestinal Manifestations in Inflammatory Bowel Diseases
Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), are complex multifactorial chronic inflammatory disorders affecting nearly 7 million patients worldwide, with an increasing prevalence in Northern Europe and emerging countries. IBD can be associated with a wide spectrum of extra-intestinal manifestations (EIMs) with a significant impact on patients’ quality of life. The pathophysiology of EIMs in IBD is intricate and uncertain. The European Crohn’s and Colitis Organization (ECCO) proposed an operational definition of EIMs’ pathology in IBD patients.
  • 565
  • 16 Jan 2024
Topic Review
Transjugular Intrahepatic Portosystemic Shunt in Hepatocellular Carcinoma Patients
Liver cancer is very frequent, and hepatocellular carcinoma (HCC) accounts for the majority of liver cancer cases. Its growing incidence has been greatly affected by the increasing prevalence of metabolic-associated fatty liver disease (MAFLD). The latter is a new epidemic in the era. In fact, HCC is often generated from noncirrhotic liver and its treatment benefits from surgical and nonsurgical approaches, potentially bridged by transjugular intrahepatic portosystemic shunt (TIPS) use. TIPS use is an effective treatment for portal hypertension complications, but its application in patients with HCC and clinically significant portal hypertension (CSPH) remains controversial due to concerns about tumor rupture, dissemination, and increased toxicity. 
  • 562
  • 24 Jul 2023
Topic Review
Advancements in Understanding NAFLD
Non-alcoholic fatty liver disease (NAFLD), recently renamed by an international consensus panel as metabolic-associated fatty liver disease (MAFLD), affects up to 1 billion patients worldwide. This change in nomenclature is in keeping with more recent understanding of this disease and its inherent link to metabolic syndrome.
  • 560
  • 14 Nov 2023
Topic Review
Oxidative Stress-Induced Cellular Senescence in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) represents a worryingly increasing cause of malignancy-related mortality, while Metabolic Associated Fatty Liver Disease (MAFLD) is going to become its most common cause. Understanding the complex underlying pathophysiology of MAFLD-related HCC can provide opportunities for successful targeted therapies. Of particular interest in this sequela of hepatopathology is cellular senescence, a complex process characterised by cellular cycle arrest initiated by a variety of endogenous and exogenous cell stressors. A key biological process in establishing and maintaining senescence is oxidative stress, which is present in multiple cellular compartments of steatotic hepatocytes. Oxidative stress-induced cellular senescence can change hepatocyte function and metabolism, and alter, in a paracrine manner, the hepatic microenvironment, enabling disease progression from simple steatosis to inflammation and fibrosis, as well as HCC. The duration of senescence and the cell types it affects can tilt the scale from a tumour-protective self-restricting phenotype to the creator of an oncogenic hepatic milieu. 
  • 559
  • 03 Jul 2023
Topic Review
Intestinal Ultrasound in Luminal Crohn’s Disease
Crohn’s disease (CD) is a chronic autoimmune disease with increasing worldwide prevalence. Small bowel involvement, either in isolation or with colonic disease, occurs in approximately 90% of patients with typical findings including ulceration, inflammation, and strictures. The current gold standard for CD activity assessment is ileocolonoscopy, however, resource constraints and the invasive nature of this assessment make this difficult to perform frequently. The recent selecting therapeutic targets in inflammatory bowel disease two (STRIDE-2) guidelines have highlighted the increasing importance of using noninvasive modalities to evaluate CD activity. Several imaging techniques can accurately assess the small bowel, including computed tomography, magnetic resonance imaging, and ultrasound. Cross-sectional imaging modalities such as magnetic resonance enterography (MRE) and computed tomography enterography (CTE).
  • 558
  • 20 Oct 2022
Topic Review
Microbiota in the Natural History of Pancreatic Cancer
Pancreatic cancer is still burdened with a severe prognosis, despite advances in the diagnosis and surgical management of this disease. The microbiota is a true organ, capable of several interactions throughout the digestive system. Microbiota can influence the development of precancerous disease predisposing to pancreatic cancer (PC). At the same time, neoplastic tissue shows specific characteristics in terms of diversity and phenotype, determining the short- and long-term prognosis.
  • 558
  • 20 Feb 2023
Topic Review
Antibiotic Therapy for Active Crohn’s Disease Targeting Pathogens
Crohn’s disease (CD) is a multifactorial chronic disorder that involves a combination of factors, including genetics, immune response, and gut microbiota. Therapy includes salicylates, immunosuppressive agents, corticosteroids, and biologic drugs. 
  • 555
  • 09 Feb 2024
Topic Review
Endosonography—Elastography
Ultrasonographic elastography is a modality used to visualize the elastic properties of tissues. Technological advances in ultrasound equipment have supported the evaluation of elastography (EG) in endosonography (EUS). Currently, the usefulness of not only EUS-strain elastography (EUS-SE) but also EUS-shear wave elastography (EUS-SWE) has been reported.
  • 549
  • 29 Jan 2022
Topic Review
Biomarkers in Inflammatory Bowel Disease
The role of biomarkers in the diagnosis of inflammatory bowel disease is not fully characterized. C-reactive protein has a short half-life and elevates quickly after the onset of an inflammatory process; the performance is better in Crohn’s disease than in ulcerative colitis. Erythrocyte sedimentation rate is easy to determine, widely available, and cheap, but the long half-life, the influence of age, anemia, smoking, and drugs limit its usefulness. Fecal markers have good specificity, but suboptimal accuracy. Microbial antibodies and novel immunological markers show promise but need further evidence before entering clinical practice. Proteomic methods could represent the dawn of a new era of stool protein/peptide biomarker panels able to select patients at risk of inflammatory bowel disease.
  • 549
  • 16 Oct 2023
Topic Review
CircRNAs in Liver Fibrosis
Liver fibrosis represents the reversible pathological process with the feature of the over-accumulation of extracellular matrix (ECM) proteins within the liver, which results in the deposition of fibrotic tissues and liver dysfunction. Circular noncoding RNAs (CircRNAs) have the characteristic closed loop structures, which show high resistance to exonuclease RNase, making them far more stable and recalcitrant against degradation. CircRNAs increase target gene levels by playing the role of a microRNA (miRNA) sponge.
  • 545
  • 19 Sep 2023
Topic Review
Biological Drugs in EoE and Their Targets
Eosinophilic esophagitis (EoE) is a multifaceted disease characterized by a wide heterogeneity of clinical manifestations, endoscopic and histopathologic patterns, and responsiveness to therapy. From the perspective of an effective approach to the patient, the different inflammatory mechanisms involved in the pathogenesis of EoE and biologics, in particular monoclonal antibodies (mAbs), targeting these pathways are needed. Currently, the most relevant is dupilumab, which interferes with both interleukin (IL)-4 and IL-13 pathways by binding IL-4 receptor α, and is the only mAb approved by the European Medicine Agency and US Food and Drug Administration for the treatment of EoE. Other mAbs investigated include mepolizumab, reslizumab, and benralizumab (interfering with IL-5 axis), cendakimab and dectrekumab (anti-IL-13s), tezepelumab (anti-TSLP), lirentelimab (anti-SIGLEG-8), and many others.
  • 540
  • 08 Feb 2024
Topic Review
High-Fat Diet in Inflammatory Bowel Disease
The intestinal immune balance is disrupted by a high-fat diet (HFD) in several ways, such as impairing the intestinal barrier, influencing immune cells, and altering the gut microbiota. In contrast, a rational diet is thought to maintain intestinal immunity by regulating gut microbiota.
  • 534
  • 25 Jun 2023
Topic Review
Assessment of Eosinophilic Esophagitis
Eosinophilic esophagitis (EoE) is an immune-mediated disease that manifests with dysphagia and is characterized by the predominantly eosinophilic infiltration of the esophageal mucosa. Several instruments have been developed to assess the symptoms of EoE.
  • 530
  • 11 Jan 2024
Topic Review
Multi-Omics in Inflammatory Bowel Disease
The notion and importance of omes, omics and multi-omics in both health and complex diseases like inflammatory bowel disease (IBD) is introduced, followed by a discussion of the various omics believed to be relevant to IBD pathogenesis, and how multi-omics “big data” can generate new insights translatable into useful clinical tools in IBD such as biomarker identification, prediction of remission and relapse, response to therapy, and precision medicine.
  • 529
  • 12 Oct 2023
Topic Review
The Contrast-Enhanced Harmonic Endoscopic Ultrasonography Fine-Needle Aspiration Technique
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is useful for the diagnosis of pancreatic masses. According to three meta-analyses, the sensitivity, specificity, and accuracy of EUS-FNA are 84–92%, 96–98%, and 86–91%, respectively. However, the occurrence of false-negative and false-positive results indicates that the diagnostic performance of EUS-FNA needs to be improved. Contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) is used for the characterization of pancreatic masses and can be applied to improve the performance of EUS-FNA. 
  • 528
  • 20 Apr 2023
Topic Review
Photodynamic, Photothermal and Photoimmune Therapy in Hepatocellular Carcinoma
Liver cancer is a malignancy that includes the structure of the liver and intrahepatic bile ducts and is classified as follows: hepatocellular carcinoma, cholangiocarcinoma, hepatic angiosarcoma (hemangiosarcoma), hepatoblastoma, and fibrolamellar carcinoma. Hepatocellular carcinoma (HCC), known also as hepatoma, is the most common type of primary liver neoplasm. HCC is known today as a major malignant disease with high morbidity and mortality, which seriously threatens the health and life span of patients. Conventional cancer therapies comprise surgical procedures, radiation therapy and chemotherapy, which may be efficient but have significant adverse effects. Newer, more prominent cancer-targeted action plans, such as the phototherapy methods including photodynamic therapy (PDT), photothermal therapy (PTT), and photoimmunotherapy (PIT), have sparked excitement and hope as synergistic multimodal cancer therapies, incorporating nanomedicine to overcome the biological barriers and to help treat cancer patients. 
  • 528
  • 15 May 2023
Topic Review
Mesenteric Ischemia
Mesenteric ischemia is a medical condition in which injury to the small intestine occurs due to not enough blood supply. It can come on suddenly, known as acute mesenteric ischemia, or gradually, known as chronic mesenteric ischemia. The acute form of the disease often presents with sudden severe abdominal pain and is associated with a high risk of death. The chronic form typically presents more gradually with abdominal pain after eating, unintentional weight loss, vomiting, and fear of eating. Risk factors for acute mesenteric ischemia include atrial fibrillation, heart failure, chronic kidney failure, being prone to forming blood clots, and previous myocardial infarction. There are four mechanisms by which poor blood flow occurs: a blood clot from elsewhere getting lodged in an artery, a new blood clot forming in an artery, a blood clot forming in the superior mesenteric vein, and insufficient blood flow due to low blood pressure or spasms of arteries. Chronic disease is a risk factor for acute disease. The best method of diagnosis is angiography, with computed tomography (CT) being used when that is not available. Treatment of acute ischemia may include stenting or medications to break down the clot provided at the site of obstruction by interventional radiology. Open surgery may also be used to remove or bypass the obstruction and may be required to remove any intestines that may have died. If not rapidly treated outcomes are often poor. Among those affected even with treatment the risk of death is 70% to 90%. In those with chronic disease bypass surgery is the treatment of choice. Those who have thrombosis of the vein may be treated with anticoagulation such as heparin and warfarin, with surgery used if they do not improve. Acute mesenteric ischemia affects about five per hundred thousand people per year in the developed world. Chronic mesenteric ischemia affects about one per hundred thousand people. Most people affected are over 60 years old. Rates are about equal in males and females of the same age. Mesenteric ischemia was first described in 1895.
  • 527
  • 07 Nov 2022
Topic Review
Thyroid Hormone and MASLD
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly termed nonalcoholic fatty liver disease (NAFLD), is a widespread global health concern that affects around 25% of the global population. Its influence is expanding, and it is anticipated to overtake alcohol as the leading cause of liver failure and liver-related death worldwide. Mitochondrial dysfunction is strongly linked to the development of MASLD. 
  • 524
  • 21 Dec 2023
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