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Topic Review
Lenvatinib for Hepatocellular Carcinoma
Lenvatinib, which is an oral multikinase inhibitor, showed non-inferiority to the sorafenib in terms of overall survival (OS) and a higher objective response rate (ORR) and better progression-free survival (PFS) in patients with hepatocellular carcinoma (HCC). A good liver function and Barcelona Clinic Liver Cancer (BCLC) intermediate stage were key factors in achieving therapeutic efficacy. The management of adverse events plays an important role in continuing lenvatinib treatment. While sequential therapies contributed to prolonging overall survival, effective molecular targeted agents for administration after lenvatinib have not been established. Repeated transcatheter arterial chemoembolization (TACE) was associated with a decline in the liver function and poor therapeutic response in BCLC intermediate patients. Recently, the Asia-Pacific Primary Liver Cancer Expert (APPLE) Consensus Statement proposed the criteria for TACE unsuitability. Upfront systemic therapy may be better for BCLC intermediate stage HCC patients with a high tumor burden, while selective TACE will be recommended to obtain a curative response in patients with a low tumor burden. This entry introduce the therapeutic response, management of adverse events, post-progression treatment after lenvatinib and treatment strategy for BCLC intermediate stage HCC.
  • 418
  • 12 Oct 2021
Topic Review
Surgical Techniques for Rectal Prolapse
Complete rectal prolapse or rectal procidentia is a debilitating disease that presents with fecal incontinence, constipation, and rectal discharge. Definitive surgical techniques described for this disease include perineal procedures such as mucosectomy and rectosigmoidectomy, and abdominal procedures such as rectopexy with or without mesh and concomitant resection. The debate over these techniques regarding the lowest recurrence and morbidity rates, and the best functional outcomes for constipation or incontinence, has been going on for decades. The heterogeneity of available studies does not allow us to draw firm conclusions. 
  • 418
  • 02 Aug 2021
Topic Review
Oral Health Status in Inflammatory Bowel Diseases Patients
Inflammatory bowel diseases (IBD) are chronic disorders that affect the gastrointestinal tract, including the oral cavity. Both Crohn’s disease (CD) and ulcerative colitis (UC) patients have an increased odds of periodontitis coincidence compared to the controls. Moreover, in most studies, patients with IBD are characterized by higher values of caries indices. In conclusion, the risk of oral diseases in IBD patients cannot be clearly established due to the possible association of other factors, e.g., sociodemographic or environmental factors.
  • 418
  • 24 Nov 2021
Topic Review
Diabetic Gastroparesis
Diabetic gastroparesis (DGP) is a debilitating gastrointestinal disorder characterized by delayed gastric emptying in individuals with diabetes mellitus, particularly type 1 and long-standing type 2 diabetes. This condition, although not widely known, significantly impacts the quality of life of affected individuals. The symptoms of DGP, including early satiety, excessive fullness after meals, loss of appetite, bloating, abdominal pain, and vomiting, stem from the slowed or stalled movement of food from the stomach to the small intestine.
  • 432
  • 28 Feb 2024
Topic Review
High-Quality Colonoscopy Components 1, 2 & 3
Colorectal cancer (CRC) continues to be the third leading cause of cancer-related deaths in the US. Colonoscopy remains the best preventative tool against the development of CRC. As a result, high-quality colonoscopy is becoming increasingly important.
  • 414
  • 09 Jun 2022
Topic Review
Polysaccharides Against Gastric Cancer
Gastric cancer is a common type of cancer that poses a serious threat to human health. Polysaccharides are important functional phytochemicals, and research shows that polysaccharides have good anti-gastric cancer effects. Researchers collated all relevant literature published from 2000 to 2020 and found that more than 60 natural polysaccharides demonstrate anti-gastric cancer activity. At the present, the sources of these polysaccharides include fungi, algae, tea, Astragalus membranaceus, Caulis Dendrobii, and other foods and Chinese herbal medicines. By regulating various signaling pathways, including the PI3K/AKT, MAPK, Fas/FasL, Wnt/β-catenin, IGF-IR, and TGF-β signaling pathways, polysaccharides induce gastric cancer cell apoptosis, cause cell cycle arrest, and inhibit migration and invasion. In addition, polysaccharides can enhance the immune system and killing activity of immune cells in gastric cancer patients and rats.
  • 413
  • 20 Sep 2022
Topic Review
Pathophysiology of Cholangiopathies
Cholestasis is a condition characterized by decrease in bile flow due to progressive pathological states that lead to chronic cholestatic liver diseases which affect the biliary tree at the intrahepatic and extrahepatic level. Cholestasis can pose risks to overall health, as the reduced flow of bile can hinder the absorption of fat-soluble vitamins and nutrients, leading to deficiencies. Additionally, it can induce other complications other such as cirrhosis, liver failure, malignancies and bone disease. Early diagnosis and adequate management are crucial in treating cholestasis in order to alleviate symptoms, prevent complications and address the underlying cause.
  • 415
  • 20 Jun 2023
Topic Review
Nonalcoholic Fatty Liver Disease Management
Nonalcoholic fatty liver disease (NAFLD) is a rising epidemic worldwide, involving more than a quarter of the world's population. A sedentary lifestyle and consuming a Western diet have led to substantial challenges in managing NAFLD patients. With no curative pharmaceutical therapies, lifestyle modifications, including dietary changes and exercise, that ultimately lead to weight loss remain the only effective therapy for NAFLD. 
  • 412
  • 09 Dec 2021
Topic Review
Dersimelagon in the Treatment of Erythropoietic Protoporphyria
Erythropoietic protoporphyria (EPP) is a genetic disorder stemming from reduced ferrochelatase expression, the final enzyme in the pathway of heme biosynthesis. A closely related condition, X-linked protoporphyria (XLP), bears similar clinical features although it arises from the heightened activity of δ-aminolevulinic acid synthase 2 (ALAS2), the first and normally rate-controlling enzyme in heme biosynthesis in developing red blood cells. Both of these abnormalities result in the buildup of protoporphyrin IX, leading to excruciating light sensitivity and, in a minority of cases, potentially fatal liver complications. Traditionally, managing EPP and XLP involved sun avoidance. However, the emergence of innovative therapies, such as dersimelagon, is reshaping the therapeutic landscape for these conditions.
  • 410
  • 05 Jan 2024
Topic Review
HCC Surveillance
Hepatocellular carcinoma (HCC) is probably the epitome of a screening target, with a well-defined high-risk population, accessible screening methods, and multiple curative-intent treatments available for early disease. 
  • 409
  • 21 Jul 2021
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