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Topic Review
Magnetic Resonance Imaging of the Gastrointestinal Tract
Magnetic resonance imaging (MRI) performed with the more advanced imaging techniques allows an accurate assessment of many intestinal disorders, particularly inflammatory bowel disease and rectal cancer; in most of these diseases, MRI is invaluable for diagnosis, staging, and monitoring under treatment. Several MRI parameters are currently considered activity biomarkers for inflammatory and neoplastic diseases. Furthermore, in younger patients with acute or chronic GI disease, MRI can be safely used for short-term follow-up studies in many critical clinical situations because it is radiation-free. MRI assessment of functional gastro-esophageal and small bowel disorders is still in its infancy but very promising, while it is well established and widely used for dynamic assessment of anorectal and pelvic floor dysfunction; MRI motility biomarkers have also been described. 
  • 565
  • 07 Aug 2023
Topic Review
Magnetic-Assisted Treatment of Liver Fibrosis
Chronic liver injury can be induced by viruses, toxins, cellular activation, and metabolic dysregulation and can lead to liver fibrosis. Hepatic fibrosis still remains a major burden on the global health systems. Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are considered the main cause of liver fibrosis. Hepatic stellate cells are key targets in antifibrotic treatment, but selective engagement of these cells is an unresolved issue. 
  • 571
  • 25 Jan 2022
Topic Review
Major Genetic Factors Involved in Liver Diseases Pathogenesis
Over the past century, our genetic background has not changed, but chronic diseases are on the rise globally. In addition to the genetic component, the critical factors for many diseases are lifestyle, eating changes, exposure to drugs, xenobiotics, alcohol, smoking, polluted air, etc. These techniques include genome-wide association studies (GWAS) that allow the identification of unknown genetic risk factors, positional cloning of unknown genes associated with different diseases, the gene tests for single nucleotide variants (SNVs), and next-generation sequencing (NGS) of selected genes or/and the entire genome. Gut microbiome composition and its metabolites are not only regulating factors in carcinogenesis (including de novo after liver transplantation) but also in xenobiotics and anticancer treatment failure, observations that may be related to the genetic background of the individuals.
  • 669
  • 21 Nov 2023
Topic Review
Management of Cholestatic Liver Diseases
Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are two chronic cholestatic liver diseases affecting bile ducts that may progress to biliary cirrhosis.
  • 379
  • 07 May 2021
Topic Review
Management of Fibro-Stenosing Crohn’s Disease
Fibro-stenosing Crohn’s disease (CD) is a common disease presentation that leads to impaired quality of life and often requires endoscopic treatments or surgery. Managing the treatment of individuals with fibro-stenosing CD is challenging and requires a multidisciplinary team comprising a gastroenterologist, a colorectal surgeon, and a radiologist to evaluate the appropriate strategy. The optimal therapeutic approach changes according to the features of the stenosis (i.e., location, length, angulation), the presence of any associated complications (i.e., fistula, abscess, dysplasia), and the patient’s preference.
  • 328
  • 10 May 2023
Topic Review
Management of Hyponatremia in Cirrhosis
Hyponatremia is a strong predictor of mortality and is also associated with an increased probability of hepatorenal syndrome, disturbance of consciousness, infections, and unfavorable post-transplant outcomes. In the management of hyponatremia, it is crucial to distinguish between hypovolemic and hypervolemic hyponatremia. The treatment of hypervolemic hyponatremia should be started only in symptomatic patients. The cessation of the treatment with traditional diuretics and fluid restriction may prevent further decrease in natremia. Pharmacological treatment is directed towards cirrhosis itself, precipitating factor, or hyponatremia directly. Currently, only albumin infusions can be recommended routinely. Other possibilities, such as vaptans, splanchnic vasoconstrictors, niravoline, or osmotic diuretics, are restricted to specific use cases (e.g., imminent liver transplantation) or need more research to determine their efficacy.
  • 202
  • 16 Oct 2023
Topic Review
Management of Inflammatory Bowel Disease and Colorectal Cancer
Patients with inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn’s disease, have an increased risk of developing colorectal cancer (CRC). Although advancements in endoscopic imaging techniques, integrated surveillance programs, and improved medical therapies have contributed to a decreased incidence of CRC in patients with IBD, the rate of CRC remains higher in patients with IBD than in individuals without chronic colitis. Patients with IBD-related CRCs exhibit a poorer prognosis than those with sporadic CRCs, owing to their aggressive histological characteristics and lower curative resection rate. 
  • 315
  • 31 Aug 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.
  • 267
  • 03 Mar 2023
Topic Review
Management of Radiation-Induced Esophageal Cancer
Radiation-induced esophageal cancer (RIEC) can arise in a previously irradiated field, mostly in patients previously irradiated for thoracic malignancies such as breast cancer, Hodgkin and non-Hodgkin lymphomas, head and neck cancers, lung cancer, or previous esophageal cancer. RIEC is rare and accounts for less than 1% of all carcinomas of the esophagus. RIEC seems to represent a biologically aggressive disease with a poor prognosis. Although it is difficult to perform radical surgery on a previously irradiated field, R0 resection remains the mainstay of treatment. The use of neoadjuvant and adjuvant chemoradiotherapy remains very helpful in RIEC, similarly to conventional esophageal cancer protocols.
  • 325
  • 01 Aug 2022
Topic Review
Mechanisms of Relationship between NAFLD and Arterial Hypertension
Non-alcoholic fatty liver disease (NAFLD) and arterial hypertension (AH) are widespread noncommunicable diseases in the global population. Since hypertension and NAFLD are diseases associated with metabolic syndrome, they are often comorbid. In fact, many contemporary published studies confirm the association of these diseases with each other, regardless of whether other metabolic factors, such as obesity, dyslipidemia, and type 2 diabetes mellites, are present.
  • 283
  • 13 Sep 2023
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