Diet Habits and Hepatocellular Carcinoma-Potential Implication for Clinical Practice.

Context: Chronic hepatitis infections and alcohol abuse traditionally have been major causes of hepatocellular carcinoma (HCC), but they are now being gradually outweighed by metabolic disorders such as obesity, type 2 diabetes, and metabolic dysfunction-associated steatotic liver disease (MASLD). Western dietary patterns along with a sedentary lifestyle are key contributors to the ongoing global metabolic disease epidemic. Little is known about the role of dietary habits in the modulation of HCC risk.

Single-port sleeve gastrectomy: a comparison between transumbilical and left hypochondrium approaches.

Background: Left hypochondrium (LHC) approach has been routinely used in our department for performing single-port sleeve gastrectomy (SPSG). Starting from 2019, a transumbilical approach (TU) has been adopted in selected patients. The aim of this study was to report and compare our results of both approaches (LHC and TU) with special focus on incisional hernia (IH).

Impact of sleeve gastrectomy on renal function in patients with morbid obesity: a 1-year prospective cohort study.

Purpose: Obesity is an independent risk factor for renal injury. A more favorable metabolic environment following weight loss may theoretically lead to improved renal function. We aimed to evaluate the evolution of renal function one year after sleeve gastrectomy in a large prospective cohort of patients with morbid obesity and assess the influence of fat-free mass (FFM) changes.

Computed tomography assessment of postoperative gastric vascular supply and staple-line leak development after sleeve gastrectomy.

Background: Residual arterial supply of the gastric tube after sleeve gastrectomy (SG) can be damaged by surgery, which can reduce gastric tube perfusion and could promote postoperative leakage.

Objective: To compare the postoperative vascularization of the gastric tube using early computed tomography (CT) scanning after SG in patients with or without postoperative staple-line leak.

Setting: University hospital.

Prevention of incisional hernia after single-port sleeve gastrectomy (PRISM): a prospective non-randomized controlled study.

Background: SPSG carries a risk of incisional hernia, particularly in patients with high body mass index. Prophylactic mesh placement with either permanent or absorbable mesh could decrease the occurrence of incisional hernia, with uncertainty on other postoperative parietal complications.

Methods: This is a non-randomized monocentric single-blinded prospective study.

Current strategies to induce liver remnant hypertrophy before major liver resection.

Hepatic resection is the gold standard for patients affected by primary or metastatic liver tumors but is hampered by the risk of post-hepatectomy liver failure. Despite recent improvements, liver surgery still requires excellent clinical judgement in selecting patients for surgery and, above all, efficient pre-operative strategies to provide adequate future liver remnant. The aim of this article is to review the literature on the rational, the preliminary assessment, the advantages as well as the limits of each existing technique for preparing the liver for major hepatectomy.

Blood microbiota and metabolomic signature of major depression before and after antidepressant treatment: a prospective case-control study.

Background: The microbiota interacts with the brain through the gut-brain axis, and a distinct dysbiosis may lead to major depressive episodes. Bacteria can pass through the gut barrier and be found in the blood. Using a multiomic approach, we investigated whether a distinct blood microbiome and metabolome was associated with major depressive episodes, and how it was modulated by treatment.

Computed Tomography Assessment of Fat Distribution and Staple-Line Leak Risk After Sleeve Gastrectomy.

Purpose: Sleeve gastrectomy (SG) has become the most frequent bariatric procedure and staple-line leak represents its most feared complication. Visceral obesity, a core component of the metabolic syndrome, has been associated with worst postoperative outcomes after various abdominal surgical procedures, and can be estimated by computed tomography (CT). The aim of this study was to assess the impact of radiologically determined visceral obesity in the risk of staple-line leak after SG.

Multikinase inhibitor-induced liver injury in patients with cancer: A review for clinicians.

Background: Multikinase inhibitors (MKI) are targeted molecular agents that have revolutionized cancer management. However, there is a paucity of data concerning MKI-related liver injury risk and clinical guidelines for the management of liver toxicity in patients receiving MKI for cancer are scarce.

Design: We conducted a PubMed search of articles in English published from January 2000 to December 2018 related to hepatotoxicity of the 29 FDA-approved MKIs at doses used in clinical practice.

Microbiota tryptophan metabolism induces aryl hydrocarbon receptor activation and improves alcohol-induced liver injury.

Objective: Chronic alcohol consumption is an important cause of liver-related deaths. Specific intestinal microbiota profiles are associated with susceptibility or resistance to alcoholic liver disease in both mice and humans. We aimed to identify the mechanisms by which targeting intestinal microbiota can improve alcohol-induced liver lesions.

Laparoscopic sleeve gastrectomy for morbid obesity in renal transplantation candidates: a matched case-control study.

Obesity has become an important issue in patients with end-stage renal disease (ESRD). Since it is considered a relative contraindication for renal transplantation, bariatric surgery has been advocated to treat morbid obesity in transplant candidates, and laparoscopic sleeve gastrectomy (LSG) is the most reported procedure. However, comparative data regarding outcomes of LSG in patients with or without ESRD are scarce.

Adaptation of controlled attenuation parameter (CAP) measurement depth in morbidly obese patients addressed for bariatric surgery.

Background And Aim: The controlled attenuation parameter (CAP) using FibroScan (Echosens, Paris, France) M or XL probe has been developed for liver steatosis assessment. However, CAP performs poorly in patients with high body mass index. The aim of our study was to assess whether CAP is overestimated using the standard XL probe in patients with morbid obesity, and in the case of an overestimation, to reprocess the data at a greater depth to obtain the appropriate CAP (CAPa).

Bile acid homeostasis and intestinal dysbiosis in alcoholic hepatitis.

Background: Intestinal microbiota plays an important role in bile acid homeostasis.

Aim: To study the structure of the intestinal microbiota and its function in bile acid homeostasis in alcoholic patients based on the severity of alcoholic liver disease.

Methods: In this prospective study, we included four groups of active alcoholic patients (N = 108): two noncirrhotic, with (noCir_AH, n = 13) or without alcoholic hepatitis (noCir_noAH, n = 61), and two cirrhotic, with (Cir_sAH, n = 17) or without severe alcoholic hepatitis (Cir_noAH, n = 17).

Predictive score of sarcopenia occurrence one year after bariatric surgery in severely obese patients.

Background And Aim: Sarcopenic obesity is a risk factor of morbidity and mortality. The aim of this study was to generate a predictive score of sarcopenia occurrence one year after bariatric surgery.

Patients And Methods: We conducted an observational prospective cohort study on a total of 184 severely obese patients admitted to our institution to undergo sleeve gastrectomy.

Characterization of intestinal microbiota in alcoholic patients with and without alcoholic hepatitis or chronic alcoholic pancreatitis.

Excessive alcohol consumption leads to severe alcoholic hepatitis (sAH) or chronic alcoholic pancreatitis (CAP) only in a subset of patients. We aimed to characterize the intestinal microbiota profiles of alcoholic patients according to the presence and nature of the complications observed: sAH or CAP. Eighty two alcoholic patients were included according to their complications: CAP (N = 24), sAH (N = 13) or no complications (alcoholic controls, AC, N = 45).

Transient elastography alone and in combination with FibroTest for the diagnosis of hepatic fibrosis in alcoholic liver disease.

Background & Aims: The reliability of transient elastography (TE) to assess liver fibrosis is insufficiently validated in alcoholic liver disease (ALD). We aimed to validate the diagnostic utility of TE for liver fibrosis in patients with excessive alcohol consumption and evaluate whether Fibrotest adds diagnostic value relative to or in combination with TE.

Methods: We conducted a multicentre prospective study on a total of 217 heavy drinkers with high serum aminotransferase levels.

Aloe vera-induced acute liver injury: A case report and literature review.

Recent data suggest that herbal and dietary supplements are the second most common cause of liver injury. We herein report a case of acute liver injury in a 68-year old female caused by ingestion of Aloe vera. Upon discontinuation of the oral Aloe vera, liver function tests (LFT) returned to normal levels.

Liver Function Test Abnormalities in Depressed Patients Treated with Antidepressants: A Real-World Systematic Observational Study in Psychiatric Settings.

Background: Concerning the risk of antidepressant induced liver injury, it is not clear whether psychiatrists perform a liver function test (LFT) and whether an increase in aminotransferase levels should contraindicate antidepressant treatment.

Aim: To evaluate LFT availability, the prevalence of LFT abnormalities and the probable cause of an altered LFT in patients with a major depressive episode (MDE) requiring an antidepressant drug.

Methods: We studied LFT evaluation in a real world psychiatric setting, in a sample of 321 consecutive patients with a current major depressive episode (MDE) requiring an antidepressant drug treatment, but without current alcohol or drug dependence or unstable medical disease.

Decreased expression of the glucocorticoid receptor-GILZ pathway in Kupffer cells promotes liver inflammation in obese mice.

Background & Aims: Kupffer cells (KC) play a key role in the onset of inflammation in non-alcoholic steatohepatitis (NASH). The glucocorticoid receptor (GR) induces glucocorticoid-induced leucine zipper (GILZ) expression in monocytes/macrophages and is involved in several inflammatory processes. We hypothesized that the GR-GILZ axis in KC may contribute to the pathophysiology of obesity-induced liver inflammation.

Disseminated tuberculosis presenting as febrile seizures with fatal evolution in an infant.

Disseminated tuberculosis with the involvement of brain, liver and gut is a rare disease in immunocompetent infant. Early diagnostic and instauration of anti-tuberculosis therapy is capital because the outcome is poor. Here, we report the case of an 11-month-old boy with disseminated tuberculosis of brain, liver abdominal lymph nodes, small bowel and lung, which presented with fever, generalized tonic-clonic seizure, hemodynamic instability and a history of recurrent respiratory tract infections.

Antidepressant-induced liver injury: a review for clinicians.

Objective: Antidepressant drugs can cause drug-induced liver injury (DILI). The authors review clinical data relevant to antidepressant-induced liver injury and provide recommendations for clinical practice.

Method: A PubMed search was conducted for publications from 1965 onward related to antidepressant-induced liver injury.