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Topic Review
Multidisciplinary Approach for Acute Colonic Obstruction Endoscopic Management
Acute colonic obstruction is one of the most common manifestations of locally advanced colorectal cancer. Endoscopic stenting has become by far the minimally invasive treatment of choice for malignant colonic obstruction especially in the palliative setting. 
  • 522
  • 23 Feb 2024
Topic Review
Metformin in Esophageal Cancer
Esophageal cancer (EC), ranking sixth in global cancer mortality, comprises two distinct diseases: esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). EAC is linked to Barrett’s esophagus (BE), influenced by factors like gastroesophageal reflux disease (GERD) and obesity, while ESSC arises from squamous cells, with tobacco and alcohol as notable risks.
  • 521
  • 14 Mar 2024
Topic Review
The Molecular Mechanisms of Lipopolysaccharides Tolerance
Lipopolysaccharides (LPSs) are complex molecules found in the outer membrane of Gram-negative bacteria, which are composed of three main regions: lipid A, core oligosaccharide, and O antigen.
  • 520
  • 09 Nov 2023
Topic Review
Percutaneous Ablation-Induced Immunomodulation in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide and its incidence is rising. Percutaneous locoregional therapies, such as radiofrequency ablation and microwave ablation, are widely used as curative treatment options for patients with small HCC, but their effectiveness remains restricted because of the associated high rate of recurrence, occurring in about 70% of patients at five years. These thermal ablation techniques have the particularity to induce immunomodulation by destroying tumours, although this is not sufficient to raise an effective antitumour immune response. Ablative therapies combined with immunotherapies could act synergistically to enhance antitumour immunity. 
  • 518
  • 09 Sep 2022
Topic Review
Microwave Ablation Techniques for Pancreatic Lesions
Thermal ablation is increasingly being utilized for the management of solid parenchymal tumors, such as hepatocellular cancer, renal tumors, thyroid nodules, and pulmonary tumors. However, its application in the management of pancreas lesions was delayed due to fears of causing iatrogenic thermal injury to the surrounding organs. The initial success of radiofrequency ablation (RFA) in inoperable pancreatic cancers led to its application in pancreatic neuroendocrine tumors and pancreatic cystic neoplasms (PCLs).
  • 516
  • 15 Nov 2023
Topic Review
Circulating Biomarkers Involved in Chronic Pancreatitis
Chronic pancreatitis (CP) is the end-stage of continuous inflammation and fibrosis in the pancreas evolving from acute- to recurrent acute-, early, and, finally, end-stage CP. Currently, prevention is the only way to reduce disease burden. In this setting, early detection is of great importance. Due to the anatomy and risks associated with direct sampling from pancreatic tissue, most of the information on the human pancreas arises from circulating biomarkers thought to be involved in pancreatic pathophysiology or injury. 
  • 516
  • 27 Feb 2024
Topic Review
Surgical Management of Gastroesophageal Junction Adenocarcinoma
Gastroesophageal (GE) junction adenocarcinoma is an aggressive malignancy of growing incidence and is associated with public health issues such as obesity and GERD. Management has evolved over the last two decades to incorporate a multidisciplinary approach, including endoscopic intervention, neoadjuvant chemotherapy/chemoradiation, and open or minimally invasive surgical approaches. Surgical approaches include esophagectomy, total gastrectomy, and, more recently, proximal gastrectomy. 
  • 515
  • 21 Feb 2024
Topic Review
Risk Stratification in Primary Biliary Cholangitis
Primary Biliary Cholangitis (PBC) is a chronic cholestatic liver disease with a heterogeneous presentation, symptomatology, disease progression, and response to therapy. The risk stratification assessment, aimed at identifying patients with a higher risk of disease progression, encompasses an in-depth analysis of demographic data, clinical and laboratory findings, antibody profiles, and the evaluation of liver fibrosis using both invasive and noninvasive techniques. Treatment response scores after one year of therapy remain to date a major factor influencing the prognosis of PBC patients. While the initial therapeutic approach with ursodeoxycholic acid (UDCA) is universally applied, new second-line treatment options have recently emerged, with many others under investigation. Consequently, the prevailing one-size-fits-all approach is poised to be supplanted by tailored strategies, ensuring high-risk patients receive the most appropriate treatment regimen from diagnosis.
  • 514
  • 15 Sep 2023
Topic Review
Diagnostic Modalities of Endoscopic Ultrasound without Biopsy
Gastric subepithelial lesions (SELs) are intramural lesions that arise underneath the gastric mucosa. SELs can be benign, but can also be malignant or have malignant potential. Their correct identification is of vital importance for a successful management. Due to their location, standard luminal endoscopy cannot determine the exact nature of these lesions. Therefore, endosonography (EUS) alone or EUS with fine needle aspiration (FNA) or fine needle biopsy (FNB) have been established as the next step in the diagnostic algorithm.
  • 513
  • 12 Jul 2023
Topic Review
Interventional Locoregional Treatments and Immunotherapy in Hepatocellular Carcinoma
Immunotherapy has remarkably revolutionized the management of advanced hepatocellular carcinoma (HCC) and prompted clinical trials, with therapeutic agents being used to selectively target immune cells rather than cancer cells. There is great interest in the possibility of combining locoregional treatments with immunotherapy for HCC, as this combination is emerging as an effective and synergistic tool for enhancing immunity. On the one hand, immunotherapy could amplify and prolong the antitumoral immune response of locoregional treatments, improving patients’ outcomes and reducing recurrence rates. On the other hand, locoregional therapies have been shown to positively alter the tumor immune microenvironment and could therefore enhance the efficacy of immunotherapy.
  • 510
  • 16 May 2023
Topic Review
Endoscopy on Reducing and Preventing Musculoskeletal Injuries
Gastrointestinal (GI) endoscopy forms an important part of the daily practice of a gastroenterologist. Its use and applicability nowadays shift from diagnostic to therapeutic fields, and it forms a significant part of the workload of the GI practitioner. Ergonomics in GI endoscopy plays an important role in occupational injury prevention. Due to a higher volume of procedures, the problem with musculoskeletal injuries is becoming bigger and everyday more present among fellow gastroenterologists.
  • 510
  • 22 Sep 2023
Topic Review
Circulating Adaptive Immune Cells in End-Stage Liver Disease
End-stage liver disease (ESLD) from acute liver failure to compensated advanced chronic liver disease and decompensated cirrhosis at different stages (chronic decompensation, acute decompensation with or without acute-on-chronic liver failure) has high disease severity and poor patient outcome. Infection is a common complication in patients with ESLD and it is associated with a high mortality rate. Multiple mechanisms are involved in this marked susceptibility to infections, noticeably the inadequate immune response known as immune paresis, as part of cirrhosis-associated immune dysfunction (CAID). Specifically in the adaptive immune arm, lymphocyte impairments—including inadequate activation, reduced ability to secrete effector molecules and enhanced immune suppressive phenotypes—result in compromised systemic immune responses and increased risk of infections. 
  • 506
  • 08 Aug 2023
Topic Review
Esophageal Mucosal Resistance in Reflux Esophagitis
Gastroesophageal reflux disease (GERD) has the highest prevalence among diseases of the digestive system and is characterized by a significant decrease in patients’ quality of life, comparable to arterial hypertension and coronary heart disease. One in every ten cases of reflux esophagitis leads to the formation of Barrett’s esophagus, which is associated with a high risk of esophagus adenocarcinoma. The key factors determining the progression of the disease are the frequency and duration of the reflux of the stomach’s contents. As a result, refluxate, which includes hydrochloric acid, pepsin, and, in the case of concomitant duodeno-gastric reflux, bile acids and lysolecithin, is thrown into the overlying sections of the digestive tract.
  • 505
  • 21 Aug 2023
Topic Review
Nlrp3 Inflammasome in Colitis-Associated Colo-Rectal Cancer
Colitis-associated colo-rectal cancer remains the leading cause of mortality in inflammatory bowel diseases, with inflammation remaining one of the bridging points between the two pathologies. The NLRP3 inflammasome complex plays an important role in innate immunity; however, its misregulation can be responsible for the apparition of various pathologies such as ulcerative colitis.
  • 504
  • 21 Feb 2023
Topic Review
Role of Exosomes in Epstein-Barr Virus-Associated Gastric Cancer
Exosomes are considered to be involved in the pathogenesis of various diseases, including cancer, viral infections, and autoimmune diseases. Epstein-Barr virus (EBV)-infected cells have been found to secrete exosomes for intercellular communication. Exosomal pathways play vital roles in the pathogenesis of EBV-related malignancies. 
  • 503
  • 10 Feb 2023
Topic Review
Appetite Regulation and Bariatric Surgery
Obesity remains a common metabolic disorder and a threat to health as it is associated with numerous complications. Lifestyle modifications and caloric restriction can achieve limited weight loss. Bariatric surgery is an effective way of achieving substantial weight loss as well as glycemic control secondary to weight-related type 2 diabetes mellitus.
  • 502
  • 27 May 2024
Topic Review
Enteric Glial Cells and Their Involvement in PD
The brain–gut axis has been identified as an important contributor to the physiopathology of Parkinson’s disease (PD).  In this pathology, inflammation is thought to be driven by the damage caused by aggregation of α-synuclein in the brain. Activation and reactive gliosis are associated to the neurodegeneration produced by Parkinson’s disease in the enteric nervous system.
  • 501
  • 26 Jan 2024
Topic Review
Tyrosine Kinase Inhibitors in BCLC-B Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) represents an entity of poor prognosis, especially in cases of delayed diagnosis. Tyrosine kinase inhibitors (TKIs) have multiple anti-tumor effects and are widely used in several types of cancers. They down-regulate different molecular pathways that take part in carcinogenesis. The primary targets are the tyrosine kinase receptors (RTKs), key proteins that regulate cancer growth and metastasis. Specifically, TKIs block the phosphorylation of tyrosine kinases and the subsequent signaling pathways, slowing down cancer growth. Some of the inhibited networks are the rat sarcoma (RAS)/mitogen-activated protein kinases (MAPKs), phosphoinositide 3-kinase (Pi3K)/protein kinase B (AKT)/mechanistic target of rapamycin (mTOR), phospholipase C (PLC)/Ca2+/calmodulin-dependent protein kinase-protein kinase C (CaMK-PKC), Janus kinase (JAK)/signal transducer and activator of transcription protein family (STAT), epidermal growth factor receptor (EGFR), vascular endothelial growth factor receptor (VEGFR), fibroblast growth factor receptor (FGFR), platelet-derived growth factor receptor (PDGFR), hepatocyte growth factor receptor (HGFR, Met), and RAF kinases. Due to their multiple actions, TKIs were the standard treatment of care in advanced HCC over the last 15 years, but after the induction of IO, they now comprise the second-line option.
  • 500
  • 27 Dec 2023
Topic Review
Endoscopic Salvage of Gastrointestinal Anastomosis Leaks
Anastomotic leakage, which is defined as a defect in the integrity of a surgical join between two hollow viscera leading to communication between the intraluminal and extraluminal compartments, continues to be of high incidence and one of the most feared complications following gastrointestinal surgery, with a significant potential for a fatal outcome. Surgical options for management are limited and carry a high risk of morbidity and mortality; thus, surgeons are urged to look for alternative options which are minimally invasive, repeatable, non-operative, and do not require general anesthesia. 
  • 499
  • 07 Oct 2023
Topic Review
Glucocorticoids in Alcoholic Hepatitis
Alcoholic hepatitis is a major health and economic burden worldwide. Glucocorticoids (GCs) are the only first-line drugs recommended to treat severe alcoholic hepatitis (sAH), with limited short-term efficacy and significant side effects.
  • 498
  • 30 Sep 2022
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