Immune and Inflammatory Pathways in Non-Alcoholic Steatohepatitis (NASH). An update

Non-alcoholic steatohepatitis (NASH), also known as fatty liver disease (FLD), is a major public health problem. It is considered to be the hepatic manifestation of the metabolic syndrome. Chronic inflammation of the liver is an essential key in the progression from simple hepatic steatosis to steatohepatitis, the evolutionary stage of fatty liver disease. Moreover, the innate immune system plays a crucial role in the progression of hepatic inflammation. For this reason, it is of utmost importance to elucidate the connections between immune mechanisms, Toll-like receptor cytokine signalling, in order to find new effective treatments. Further studies are necessary to test theories presented in this paper. The elucidation of mechanisms underlying the progression of hepatic steatosis towards steatohepatitis is essential for the development of useful diagnosis and treatment for medical practice

Hepatocarcinoma with tumor thrombus occupying the right atrium and portal vein in a patient with hereditary hemochromatosis and liver cirrhosis

We present the case of a 46-year old patient with Child-Pugh class C cirrhosis with MEDL-Score 16, and hepatocellular carcinoma invading the inferior vena cava and the right atrium. The etiology of cirrhosis is type 1 hereditary hemochromatosis with positive HFE C282Y/C282Y and H63D/H63D mutations. A systematic review of the literature was performed and only 30 cases of hepatocellular carcinoma with tumor thrombosis extending into the right atrium have been described. To our knowledge, this is the first case that evidences the presence in hereditary hemochromatosis of hepatocellular carcinoma with atypical invasion into the right atrium. Screening of patients with a family history of hereditary hemochromatosis allows detection of the disease in the asymptomatic phase, allowing initiation of early therapy and improved prognosis

Imatinib-induced interstitial pneumonitis – a literature review and case report

Imatinib is generally well tolerated, with mild common side effects such as nausea and vomiting, diarrhea, muscle cramps, fatigue, skin rash and edema; however, pulmonary complications are uncommon. A 73-year-old woman undergoing one month treatment with Imatinib for chronic myeloid neoplasm associated with eosinophilia was admitted for sudden alteration of her performance status, dyspnea at rest and productive cough. On clinical examination, the patient was hypoxic (oxygen saturation on room air was 87%), and auscultation of her lungs revealed diffuse bilateral fine crackles. Computed tomography showed bilateral pulmonary interstitial syndrome. Imatinib was discontinued and the patient received systemic corticosteroid therapy and oxygen therapy. After one month, the symptoms and radiological findings were resolved. When Imatinib therapy was resumed, respiratory symptoms reappeared, which is why treatment with Imatinib was interrupted. Imatinib-induced pneumonitis should take into consideration when patients develop respiratory symptoms or abnormal pulmonary radiological features

Thrombocytopenia in end-stage renal disease and chronic viral hepatitis B or C

Objectives. We evaluated platelet counts in end-stage renal disease and chronic viral hepatitis. Materials and Methods. We studied 70 patients with end-stage renal disease and chronic viral hepatitis and compared them to a control group of 45 patients without hepatitis. Results. The presence of viral hepatitis was associated with a higher prevalence of thrombocytopenia. Correlations between age, C-reactive protein, liver stiffness measurement, and platelet count were observed. C-reactive protein levels \u3e 10 mg/dl were associated with a lower risk of thrombocytopenia in patients with end-stage renal disease and chronic viral hepatitis, yet age \u3e 60 years, dialysis vintage \u3e 10 years, aspartate and alanine aminotransferase levels \u3e 20 IU/L, albumin levels \u3c 3.5 g/dl, and fibrosis stage ≥ 3 were not related. Conclusions. Chronic viral hepatitis leads to a higher prevalence of thrombocytopenia. Platelet counts in these patients begin to decrease significantly once liver fibrosis reaches stage III

Immune and Inflammatory Pathways in Non-Alcoholic Steatohepatitis (NASH). An update

Non-alcoholic steatohepatitis (NASH), also known as fatty liver disease (FLD), is a major public health problem. It is considered to be the hepatic manifestation of the metabolic syndrome. Chronic inflammation of the liver is an essential key in the progression from simple hepatic steatosis to steatohepatitis, the evolutionary stage of fatty liver disease. Moreover, the innate immune system plays a crucial role in the progression of hepatic inflammation. For this reason, it is of utmost importance to elucidate the connections between immune mechanisms, Toll-like receptor cytokine signalling, in order to find new effective treatments. Further studies are necessary to test theories presented in this paper. The elucidation of mechanisms underlying the progression of hepatic steatosis towards steatohepatitis is essential for the development of useful diagnosis and treatment for medical practice

Coping Strategies and Irritable Bowel Syndrome: A Systematic Review.

Background and Aims: Irritable bowel syndrome (IBS) is associated with a high prevalence of psychiatric comorbidities. While psychosocial determinants were intently studied, coping strategies with stress used by IBS patients were never comprehensively reviewed. Therefore, this systematic review aimed to summarize the coping strategies used by IBS patients and to identify which tools are frequently used to measure coping strategies. Methods: According to PRISMA guidelines, we searched for articles indexed in PubMed, EBSCOhost, EMBASE and Cochrane Library. The search terms included: (coping OR coping strategies OR coping mechanism) AND (irritable bowel syndrome OR IBS). The initial search identified 756 articles. After applying all filters (human filters, excluding conference abstracts and conference papers), 96 studies remained. Finally, a total of 21 articles were included in this systematic review. Results: Twenty-one articles using fifteen coping instruments and six measures of quality of life were found. One was interventional, one longitudinal, and the rest were cross-sectional studies. One study was qualitative, while the rest used quantitative measures. Emotion-focused coping was associated with worse psychological outcomes, while the effect of problem-focused coping was not regularly associated with better psychological outcomes. Catastrophizing was negatively associated with health-related quality of life. Psychological distress (anxiety, depression) was significantly related to the impairment of health-related quality of life. Conclusion: Patients with IBS cope in different ways when confronted with health and daily-life stressors. The maladaptive strategy of coping is associated with poor health-related quality of life and psychiatric comorbidities but methodological problems limit conclusions regarding the strength and nature of this association. Future research needs to focus on which strategies are most effective at reducing psychological distress in IBS patients

Applications of artificial intelligence in musculoskeletal ultrasound: narrative review

Ultrasonography (US) has become a valuable imaging tool for the examination of the musculoskeletal system. It provides important diagnostic information and it can also be very useful in the assessment of disease activity and treatment response. US has gained widespread use in rheumatology practice because it provides real time and dynamic assessment, although it is dependent on the examiner’s experience. The implementation of artificial intelligence (AI) techniques in the process of image recognition and interpretation has the potential to overcome certain limitations related to physician-dependent assessment, such as the variability in image acquisition. Multiple studies in the field of AI have explored how integrated machine learning algorithms could automate specific tissue recognition, diagnosis of joint and muscle pathology, and even grading of synovitis which is essential for monitoring disease activity. AI-based techniques applied in musculoskeletal US imaging focus on automated segmentation, image enhancement, detection and classification. AI-based US imaging can thus improve accuracy, time efficiency and offer a framework for standardization between different examinations. This paper will offer an overview of current research in the field of AI-based ultrasonography of the musculoskeletal system with focus on the applications of machine learning techniques in the examination of joints, muscles and peripheral nerves, which could potentially improve the performance of everyday clinical practice

Reducing cardiovascular burden in psoriasis patients by using specific therapies – How close are we?

Psoriasis is a chronic, systemic inflammatory disease that has gained popularity among scientific research from many promising perspectives on diagnosis and treatment. Individuals with psoriasis associate numerous comorbidities and have many predisposing factors in common especially with heart disease. Based on this, researchers tried to identify the common pathogenic mechanisms, the impact of risk factors on both pathologies, the influence of one disease on the another as well as the impact of novel therapies used in psoriasis on cardiovascular system, in order to improve the prognosis and quality of life of these patients. Areas of uncertainty. Pathogenic mechanisms involved both in psoriasis and atherosclerotic disease are not fully understood, especially in relationship with actual treatment strategies and their impact on prognosis. The purpose of this descriptive review is to summarize the latest available data, to see whether current treatment strategies of psoriatic disease should take into consideration the risk of cardiovascular disease (CVD) when one drug should be chosen at the expense of another. Data sources. Literature research was performed using electronic database (PubMed, Cochrane Library and Web of Science) between January 2010 and June 2022. We used different keywords and MeSH terms to generate the most relevant results regarding psoriasis and cardiovascular disease. First, we evaluated the titles and abstracts of the articles and we excluded papers that didn’t met selection criteria

Thrombocytopenia in end-stage renal disease and chronic viral hepatitis B or C

Objectives. We evaluated platelet counts in end-stage renal disease and chronic viral hepatitis. Materials and Methods. We studied 70 patients with end-stage renal disease and chronic viral hepatitis and compared them to a control group of 45 patients without hepatitis. Results. The presence of viral hepatitis was associated with a higher prevalence of thrombocytopenia. Correlations between age, C-reactive protein, liver stiffness measurement, and platelet count were observed. C-reactive protein levels \u3e 10 mg/dl were associated with a lower risk of thrombocytopenia in patients with end-stage renal disease and chronic viral hepatitis, yet age \u3e 60 years, dialysis vintage \u3e 10 years, aspartate and alanine aminotransferase levels \u3e 20 IU/L, albumin levels \u3c 3.5 g/dl, and fibrosis stage ≥ 3 were not related. Conclusions. Chronic viral hepatitis leads to a higher prevalence of thrombocytopenia. Platelet counts in these patients begin to decrease significantly once liver fibrosis reaches stage III

Immune and Inflammatory Pathways in Non-Alcoholic Steatohepatitis (NASH). An update

Non-alcoholic steatohepatitis (NASH), also known as fatty liver disease (FLD), is a major public health problem. It is considered to be the hepatic manifestation of the metabolic syndrome. Chronic inflammation of the liver is an essential key in the progression from simple hepatic steatosis to steatohepatitis, the evolutionary stage of fatty liver disease. Moreover, the innate immune system plays a crucial role in the progression of hepatic inflammation. For this reason, it is of utmost importance to elucidate the connections between immune mechanisms, Toll-like receptor cytokine signalling, in order to find new effective treatments. Further studies are necessary to test theories presented in this paper. The elucidation of mechanisms underlying the progression of hepatic steatosis towards steatohepatitis is essential for the development of useful diagnosis and treatment for medical practice