Exploring the interplay between metabolic dysfunction-associated fatty liver disease and gut dysbiosis: Pathophysiology, clinical implications, and emerging therapies.

Metabolic dysfunction-associated fatty liver disease (MAFLD) now affects roughly one-quarter of the world's population, reflecting the global spread of obesity and insulin resistance. Reframing non-alcoholic fatty liver disease as MAFLD emphasizes its metabolic roots and spotlights the gut-liver axis, where intestinal dysbiosis acts as a key driver of hepatic injury. Altered microbial communities disrupt epithelial integrity, promote bacterial translocation, and trigger endotoxin-mediated inflammation that accelerates steatosis, lipotoxicity, and fibrogenesis.

A novel anatomically guided strategy for evaluation of sufficient myotomy during peroral endoscopic myotomy in patients with achalasia.

Background And Aims: Peroral endoscopic myotomy (POEM) necessitates proper orientation of the anatomical landmarks throughout the whole procedure to assess the myotomy, which is the main target of POEM. Insufficient myotomy renders the procedure ineffective and may lead to nonresponse or recurrence, although longer myotomy may increase the risk of reflux. The current conventional methods for esophagogastric junction (EGJ) detection are often operator-dependent, time-consuming, and have questionable accuracy.

Practical approach to linear endoscopic ultrasound examination of the gallbladder.

The gallbladder (GB) is a susceptible organ, prone to various pathologies that can be identified using different imaging techniques. Transabdominal ultrasound (TUS) is typically the initial diagnostic method due to its numerous well-established advantages. However, in cases of uncertainty or when a definitive diagnosis cannot be established, computed tomography (CT) or magnetic resonance imaging may be employed to provide more detailed information.

Recent Advances in Protective Vaccines against Hepatitis Viruses: A Narrative Review.

Vaccination has been confirmed to be the safest and, sometimes, the only tool of defense against threats from infectious diseases. The successful history of vaccination is evident in the control of serious viral infections, such as smallpox and polio. Viruses that infect human livers are known as hepatitis viruses and are classified into five major types from A to E, alphabetically.

Practical approach to linear endoscopic ultrasound examination of the rectum and anal canal.

Standard endosonographic examination of the rectal area is usually performed with radial endoscopic ultrasound (EUS). However, in recent years, widespread availability of linear EUS for assessing various anatomical regions in the gastrointestinal tract has facilitated its use in the assessment of anorectal disorders. Currently, many rectal and anal diseases, including perianal abscesses, fistulae, polyps, and neoplastic lesions, can be well-visualized and evaluated with linear EUS.

Practical approach to linear EUS examination of the mediastinum.

EUS has become a substantial diagnostic and therapeutic modality for many anatomical regions. The extent of endosonographic assessment is wide, and among others, allows for the evaluation of the mediastinal anatomy and related pathologies such as mediastinal lymphadenopathy and staging of central malignant lung lesions. Moreover, EUS assessment has proved more accurate in detecting small lesions missed by standard imaging examinations such as computed tomography or magnetic resonance.

EUS-guided cholecystoduodenostomy using novel dumbbell-shaped fully covered metal stent (with video).

Highlight Atalla and colleagues present a novel dumbbell-shaped fully covered self-expandable metal stent which, with its anti-migration property and relatively lower cost, is a feasible and cost-effective option as an alternative to lumen-apposing metal stents for endoscopic ultrasound-guided transduodenal gallbladder drainage for acute cholecystitis in patients who are ineligible for surgery.

EUS-guided drainage for a non-dilated pancreatic duct using a re-puncture technique in a patient with stricture-related pancreatitis (with video).

Highlight EUS-guided pancreatic duct drainage has emerged as an effective method for the treatment of post-pancreaticojejunostomy anastomotic stricture, but cases with non-dilated pancreatic duct usually represent a great challenge. Fujigaki and colleagues demonstrate the feasibility of EUS-guided pancreatic duct drainage with the re-puncture technique in a case with non-dilated pancreatic duct.