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Topic Review
Biography
Topic Review
Endoscopic of the Upper Digestive Tract Management
The European Society for Gastrointestinal Endoscopy recommends immediate (<2 h, maximum 6 h after ingestion) therapeutic endoscopy for foreign bodies causing complete obstruction, sharp objects and batteries or magnets. Urgent endoscopy (<24 h) should also be performed for other esophageal foreign bodies without complete obstruction. Endoscopy of the upper digestive tract is very sensitive in detecting foreign bodies and has the advantage that therapeutic maneuvers can be performed. In addition, endoscopy may reveal pre-existing esophageal pathology leading to obstruction and any mucosal damage.
640
27 Mar 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.
305
27 Mar 2023
Topic Review
Inflammatory Bowel Diseases
Liver disease is one of the most common extraintestinal manifestations of inflammatory bowel disease (IBD). IBD cause chronic inflammation and can affect various sections of the gastrointestinal tract. A particular form of inflammatory bowel disease is inflammatory bowel disease (IBD).
522
27 Mar 2023
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.
329
21 Mar 2023
Topic Review
MRE Parameters That Correlate with Disease Activity
Crohn’s disease (CD) is a chronic immune mediated disorder that most commonly affects the small bowel and/or the large bowel. Treatment targets in CD include mucosal healing assessed via ileocolonoscopy and transmural healing assessed through cross-sectional imaging modalities such as magnetic resonance enterography (MRE).
338
20 Mar 2023
Topic Review
New-Onset Liver Injuries Due to COVID-19
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted the world and caused the 2019 coronavirus disease (COVID-19) pandemic. The clinical manifestations of the virus can vary from patient to patient, depending on their respective immune system and comorbidities. SARS-CoV-2 can affect patients through two mechanisms: directly by targeting specific receptors or by systemic mechanisms.
406
17 Mar 2023
Topic Review
Prognostic and Predictive Biomarkers in Familial Breast Cancer
Large numbers of breast cancers arise within a familial context, either with known inherited germline mutations largely within DNA repair genes, or with a strong family history of breast and/or ovarian cancer, with unknown genetic underlying mechanisms. These cancers appear to be different to sporadic cases, with earlier age of onset, increased multifocality and with association with specific breast cancer histological and phenotypic subtypes. Furthermore, tumours showing homologous recombination deficiency, due to loss of BRCA1, BRCA2, PALB2 and CHEK2 function, have been shown to be especially sensitive to platinum-based chemotherapeutics and PARP inhibition.
326
15 Mar 2023
Topic Review
Diagnostic Methods for Evaluation of Gastric Motility
Gastric motility abnormalities are common in patients with disorders of gut-brain interaction such as functional dyspepsia and gastroparesis. Accurate assessment of the gastric motility in these common disorders can help understand the underlying pathophysiology and guide effective treatment. A variety of clinically applicable diagnostic methods have been developed to objectively evaluate for presence of gastric dysmotility, including tests of gastric accommodation, antroduodenal motility, gastric emptying, and gastric myoelectrical activity. The advances in clinically available diagnostic methods for evaluation of gastric motility are discussed and the advantages and disadvantages of each test are described.
410
15 Mar 2023
Topic Review
OCA on Different Physiological Processes through FXR Activation
Obeticholic acid (OCA) or 6-alpha-ethyl-chenodeoxycholic acid is a semisynthetic modified bile acid derivative that acts on the farnesoid X receptor (FXR) as an agonist with a higher potency than bile acid. The FXR is a nuclear receptor highly expressed in the liver and small intestine and regulates bile acid, cholesterol, glucose metabolism, inflammation, and apoptosis.
514
08 Mar 2023
Topic Review
Management of Pediatric Feeding Disorder
Pediatric feeding disorder (PFD) is defined as impaired oral intake that is not age appropriate and is associated with at least one dysfunctional domain: medical; nutritional; feeding skills; and psychosocial Feeding difficulties take time to resolve and are best managed in progressive phases. A series of short-term goals are typically developed that can lead to complex interdisciplinary coordination of care. Using a stepwise treatment approach to PFD is important because, even though feeding problems are relatively common—occurring in up to 45% of children in the general population—the condition is severe enough to warrant intensive intervention in about 10%. A stepwise approach ensures that feeding problems are not overlooked or treated inappropriately.
266
03 Mar 2023
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