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Topic Review
First-and Second-Line Therapies for Primary Biliary Cholangitis
Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease characterized by the progressive destruction of the intrahepatic bile ducts. Currently, the first line drug for PBC is ursodeoxycholic acid characterized by anti-apoptotic, anti-inflammatory and protective actions on cholangiocytes. 
  • 1.1K
  • 21 Mar 2022
Topic Review
Classification and Diagnosis of Acute Pancreatitis
The pancreas is a glandular organ that is responsible for the proper functioning of the digestive and endocrine systems, and therefore, it affects the condition of the entire body. Consequently, it is important to effectively diagnose and treat diseases of this organ. According to clinicians, pancreatitis—a common disease affecting the pancreas—is one of the most complicated and demanding diseases of the abdomen. The classification of pancreatitis is based on clinical, morphologic, and histologic criteria. Medical doctors distinguish, inter alia, acute pancreatitis (AP), the most common causes of which are gallstone migration and alcohol abuse.
  • 1.0K
  • 30 Aug 2022
Topic Review
Therapeutic Targeting of Intestinal Fibrosis in Crohn’s Disease
Intestinal fibrosis is one of the most threatening complications of Crohn’s disease. Endoscopic and surgical approaches are currently the only options available and there is an urgent need for targeted anti-fibrotic therapy. Several molecules investigated in preclinical studies, which are awaiting clinical trials in humans, have proven effective in CD stricturing phenotype and may be available in the near future as additional weapons in preventing or reversing intestinal fibrosis. 
  • 1.0K
  • 24 Mar 2022
Topic Review
Inflammatory Bowel Disease
The conventional approach to IBD aims to induce and maintain clinical remission free of corticosteroids, thus minimizing the impact on quality of life.(1) Currently, corticosteroids, sulfasalazine, mesalamine (5-ASA), and immunomodulators are treatment options for patients with IBD. Studies indicate that a substantial proportion of patients do not fully respond to conventional treatment for IBD or that its efficacy wanes over time.(2) Corticosteroid resistance/refractoriness rates range from 8.9% to 25% in individuals with IBD.(3, 4) Identifying safe and effective therapeutic agents for complementary therapy remains an unmet need for these patients. Curcumin also acts by inhibiting the activity of pro-inflammatory proteins such as activated protein-1, peroxisome proliferator-activated receptor gamma, signal translators, and transcription activators, as well as the expression of b-catenin, cyclooxygenase 2, 5-lipoxygenase, and inducible nitric oxide synthase isoform, which play a key role in inflammation.(5) In addition, it acts by blocking the binding between TNF-α and its receptor, preventing the perpetuation of inflammation caused by this cytokine.(6) Curcumin's excellent anti-inflammatory profile makes it a promising therapeutic agent in the treatment of IBD. 
  • 1.0K
  • 05 Nov 2020
Topic Review
Endoscopic Ultrasound-Guided Hepaticogastrostomy
Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is widely performed worldwide for various benign and malignant biliary diseases in cases of difficult or unsuccessful endoscopic transpapillary cholangiopancreatography (ERCP). Furthermore, its applicability as primary drainage has also been reported. Although recent advances in EUS systems and equipment have made EUS-HGS easier and safer, the risk of serious adverse events such as bile leak and stent migration still exists. Physicians and assistants need not only sufficient skills and experience in ERCP-related procedures and basic EUS-related procedures such as fine needle aspiration and pancreatic fluid collection drainage, but also knowledge and techniques specific to EUS-HGS.
  • 1.0K
  • 08 Apr 2022
Topic Review
Iron Deficiency in Celiac Disease
Iron deficiency anemia (IDA) is the most recognized type of anemia in patients with celiac disease (CD) and may be present in over half of patients at the time of diagnosis. Folate and vitamin B12 malabsorption, nutritional deficiencies, inflammation, blood loss, development of refractory CD, and concomitant Heliobacter pylori infection are other causes of anemia in such patients. The decision to replenish iron stores and the route of administration (oral or intravenous) are controversial due, in part, to questions surrounding the optimal formulation and route of administration.
  • 1.0K
  • 09 Oct 2021
Topic Review
Growth and Puberty in IBD
Inflammatory bowel diseases are characterized also by retarded growth and delayed puberty. The underlying mechanism of these and other extra-intestinal manifestations are partially known: the main hypotheses are malnutrition and inflammatory response.
  • 1.0K
  • 06 Nov 2020
Topic Review
Feeding Problems in Patients with Noonan Syndrome
Noonan syndrome (NS) belongs to the group of Noonan syndrome spectrum disorders (NSSD), which is a group of phenotypically related conditions. Feeding problems are often present not only in infancy but also in childhood, and even beyond that period. More than 50% of infants with NS develop feeding problems, and up to half of these infants will be tube-dependent for some time. Although, in general, there is a major improvement between the age of 1 and 2 years, with only a minority still having feeding problems after the age of 2 years, as long as the feeding problems continue, the impact on the quality of life of both NS infants and their caregivers may be significant. Feeding problems in general improve faster in children with a pathogenic PTPN11 or SOS1 variant. The mechanism of the feeding problems is complex, and may be due to medical causes (gastroesophageal reflux disease and delayed gastric emptying, cardiac disease and infections), feeding-skill dysfunction, nutritional dysfunction with increased energy demand, or primary or secondary psychosocial dysfunction. Many of the underlying mechanisms are still unknown. The treatment of the feeding problems may be a medical challenge, especially when the feeding problems are accompanied by feeding-skill dysfunction and psychosocial dysfunction. 
  • 999
  • 17 Feb 2022
Topic Review
Immune Checkpoint Inhibitor-Related Pancreatitis
The indications for immune checkpoint inhibitors (ICIs) have expanded to include carcinomas of various organs. ICIs include drugs that target programmed cell death-1 (PD-1), programmed cell death ligand 1 (PDL-1), and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4). The indications for these drugs have been expanded to include many types of cancer, as efficacies have been reported for malignant melanoma and lung, kidney, head and neck, stomach, liver, ovarian, and pancreatic cancers .
  • 990
  • 05 May 2022
Topic Review
Food's Effect for Endotoxemia
Endotoxemia and hyperinflammation are important factors for determining the severity of infectious and non-infectious disease. The most important endotoxin is LPS, lipopolysaccharide, which is present at high concentrations in the intestine as part of the intestinal bacterial flora. The LPS from these bacteria can induce a chronic subclinical inflammatory process under certain circumstances.
  • 990
  • 09 Sep 2021
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