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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.
  • 308
  • 07 Oct 2023
Topic Review
The Melanocortin System in Inflammatory Bowel Diseases
The melanocortin system is a complex set of molecular mediators and receptors involved in many physiological and homeostatic processes. These include the regulation of melanogenesis, steroidogenesis, neuromodulation and the modulation of inflammatory processes. In the latter context, the system has assumed importance in conditions of chronic digestive inflammation, such as inflammatory bowel diseases (IBD), in which numerous experiences have been accumulated in mouse models of colitis.
  • 484
  • 28 Sep 2023
Topic Review
Screening for NAFLD in the Outpatient Pharmacy
Non-alcoholic fatty liver disease (NAFLD) stands as an increasingly pressing global health challenge, underscoring the need for timely identification to facilitate effective treatment and prevent the progression of chronic liver disorders. Given the projected scarcity of specialized healthcare professionals, particularly hepatologists and gastroenterologists, the role of pharmacists emerges as pivotal in NAFLD management. 
  • 321
  • 28 Sep 2023
Topic Review
Non-Alcoholic Steatohepatitis-Driven Hepatocarcinogenesis
Non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (NASH) are chronic hepatic conditions leading to hepatocellular carcinoma (HCC) development. According to the recent “multiple-parallel-hits hypothesis”, NASH could be caused by abnormal metabolism, accumulation of lipids, mitochondrial dysfunction, and oxidative and endoplasmic reticulum stresses and is found in obese and non-obese patients.
  • 119
  • 27 Sep 2023
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. 
  • 360
  • 26 Sep 2023
Topic Review
The Intestinal Microbiota in Chronic Liver Disease
Chronic liver disease (CLD) is a significant global health burden, leading to millions of deaths annually. The gut–liver axis plays a pivotal role in this context, allowing the transport of gut-derived products directly to the liver, as well as biological compounds from the liver to the intestine. The gut microbiota plays a significant role in maintaining the health of the digestive system. A change in gut microbiome composition as seen in dysbiosis is associated with immune dysregulation, altered energy and gut hormone regulation, and increased intestinal permeability, contributing to inflammatory mechanisms and damage to the liver, irrespective of the underlying etiology of CLD.
  • 328
  • 26 Sep 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.
  • 331
  • 26 Sep 2023
Topic Review
The Role of Cholangioscopy in Biliary Diseases
Endoscopy plays a central role in diagnostic and therapeutic approaches to biliary disease in both benign and malignant conditions. A cholangioscope is an endoscopic instrument that allows for the direct exploration of the biliary tree. Cholangioscopy has demonstrated excellent performance in discriminating malignant conditions (such as colangiocarcinoma) from benign inflammatory strictures, and more advances (e.g., artificial intelligence and confocal laser endomicroscopy) could further increase its diagnostic accuracy. Cholangioscopy also plays a primary role in the treatment of benign conditions such as difficult bile stones (DBSs). 
  • 176
  • 25 Sep 2023
Topic Review
Surveillance and Diagnosis of NAFLD-Related Hepatocellular Carcinoma
With the significant achievements in eradicating the hepatitis C virus by direct-acting antiviral agents and the rising epidemic of obesity, diabetes mellitus, and metabolic syndrome, there is a paradigm shift in the leading cause of liver cirrhosis and cancer to nonalcoholic fatty liver disease (NAFLD). Data highlight the rapidly rising incidence of NAFLD-related hepatocellular carcinoma (HCC) worldwide and expose the unseen part of the iceberg. NAFLD-related HCC has some characteristic features that distinguish it from other etiologies such as HBV and HCV, which makes its diagnosis and management more complicated. 
  • 223
  • 25 Sep 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.
  • 263
  • 22 Sep 2023
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