Obesity is a complex disease resulting from excessive adipose tissue in the body, leading to various metabolic, mechanical, and psychological complications. The prevalence of obesity has increased exponentially in the past few decades to reach an epidemic proportion. Obesity can predispose to or aggravate the fatty liver. Metabolic dysfunction-associated fatty liver disease (MAFLD) represents fatty liver in individuals who are either overweight/obese, or have type 2 diabetes, or have normal weight with at least two metabolic risk factors. MAFLD pathogenesis is multifactorial and involves an interplay of genetics, lifestyle-related factors, gut dysbiosis, lipotoxicity, and oxidative stress. Besides hepatic complications, MAFLD also has systemic implications in the form of increased risk for various metabolic diseases, cardiovascular diseases, malignancies, and infectious diseases. If left untreated, MAFLD can progress to liver cirrhosis and end-stage liver disease. Many noninvasive strategies like serum-based markers and imaging help diagnose MAFLD at an early stage. Timely detection and appropriate intervention are crucial for preventing its progression to advanced liver disease and hepatocellular carcinoma. Though lifestyle modification remains the main pillar of management, with advances in the treatment of obesity, newer agents are being tried for patients with MAFLD. The current therapeutic strategies are limited, and future research is needed to identify the subset of patients with MAFLD who are at a higher risk of hepatic and systemic complications and to develop more effective and personalized therapies.

Dietary management is one of the top research interests in the field of human cancer, but due to the heavy focus of cancer studies mainly on detection and medical treatment, the role of nutrition in prevention has generally received little research attention, and standards of care in cancer treatment do not effectively consider diet-based interventions as either an alternative or a complementary practice. It is generally believed that an unbalanced diet, unhealthy dietary patterns, and the consumption of nutrient-deficient foods contribute to the occurrence of various cancers. In contrast, adequate consumption of healthy, natural foods rich in essential nutrients may reduce the risk of cancer and help cancer patients better recover from the adverse effects of medical treatments. However, little is known about how dietary interventions interact with cancer. This study aims to provide an overview of several major dietary cancer risk factors and protective measures, as well as nutritional recommendations for the management of this disease. Moreover, based on the Warburg hypothesis, several potential dietary interventions have been identified to help maintain nutritional balance and reduce cancer risk. The findings of this study suggest that a balanced healthy diet with alkalizing and anti-inflammatory properties may be effective for maintaining certain aspects of health and reducing the risk of developing cancer. Further research should be performed to explore whether such dietary interventions could have an impact on the incidence or development of cancer.

In this systematic review, we assessed the efficacy, potential mechanisms, and safety of two neuromodulation therapies in patients with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. The first therapy is vagus nerve stimulation (VNS) utilizing implantable or transcutaneous electrodes, and the second is sacral nerve stimulation (SNS) using implantable or percutaneous electrodes.

We conducted a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed database was comprehensively searched, and studies were rigorously assessed for inclusion and exclusion criteria.

Our analysis encompassed five clinical studies, three on VNS and two on SNS. Most investigated studies demonstrated significant beneficial effects on IBD symptoms, including disease activity, severity of intestinal lesions, and intestinal pain. When evaluating the impact on key IBD pathophysiologies, both VNS and SNS exhibited trends toward reducing biomarkers of intestinal mucosal inflammation and mitigating sympathetic dominance. Importantly, none of the evaluated neuromodulation methods resulted in long-term adverse effects.

Cumulative evidence from the evaluated studies indicates that VNS and SNS therapies effectively alleviate IBD symptoms and may hold promise in addressing the underlying pathophysiologies of IBD, including intestinal mucosal inflammation and sympathetic dominance. Consequently, they represent valuable options for individualized IBD treatment.

Multiple factors are responsible for severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2)-associated liver dysfunction. The impact of variants of concern (VoCs) on liver function is less clear. The aims were to determine (1) the prevalence and risk of abnormal liver biochemistry (ALB) and liver injury (LI) and (2) differences in ALB and LI with the Delta variant compared with wild-type and VoCs before Delta variant coronavirus disease of 2019 (COVID-19) infections in Malaysian adults.

This prospective single-center, observational study enrolled adults hospitalized for COVID-19 infection between 1 February 2020 and 30 October 2021 using a convenience sampling method. Patients with COVID-19 confirmed by real-time reverse-transcriptase polymerase chain reaction of nasal and pharyngeal swabs and having at least one liver function test were recruited and assigned to cohort A (wild-type strain and all VoCs before the Delta variant) or cohort B (Delta variant).

Of 1,246 patients with COVID-19 infection, 58.7% developed ALB and 26.6% developed LI. Multivariate analysis showed that men, moderate and severe disease, and underlying chronic liver disease (CLD) were associated with ALB and LI. Patients with the Delta variant had a significantly higher risk of developing both ALB (71.6% vs. 48.5%, p < 0.001) and LI (38.8% vs. 17.1%, p < 0.001) compared with previous strains.

ALB was more common than LI, but LI was more frequent in men with underlying CLD, and in those with moderate or severe COVID-19 infections. Patients with Delta variant infections were more likely to have ALB and LI than those with precedent strains.

fatigue is a common symptom in patients with malignant tumors, which seriously affects patient quality of life and even the progress of treatment. There have been numerous studies on various aspects of cancer-related fatigue. This review summarizes and analyzes its pathogenesis, screening, evaluation, and treatment from the perspectives of modern medicine and traditional Chinese medicine (TCM). Modern medicine believes that the pathogenesis of cancer-related fatigue is still unclear. Screening assessment scales are varied and have different focuses, so they should be selected and used comprehensively. Drug intervention for cancer-related fatigue has safety problems and is not recommended for conventional treatment. Non-drug treatment methods such as exercise, psychological intervention, diet guidance, and light therapy have good efficacy and high safety and are worthy of clinical promotion. In TCM, cancer fatigue is included as a deficiency. The syndrome of TCM is divided into two categories: deficiency syndrome and syndrome of intermingled deficiency and excess, involving the three viscera, the liver, spleen, and kidney that are closely related to the pathological products of blood stasis, toxin, phlegm, and dampness. The TCM diagnosis and evaluation scale is still in its infancy, which objectively quantifies TCM syndromes, forms a unified diagnostic standard for TCM syndrome differentiation, and standardizes TCM syndrome differentiation and treatment. The elements of syndromes open the idea of constructing a TCM scale. TCM offers various treatment and nursing methods that have high efficacy and safety. TCM, acupuncture, moxibustion, and traditional exercises are the main methods, but high-quality evidence is needed. In the future, the advantages of the combination of TCM and Western medicine should be used to overcome cancer-related fatigue.

Primary biliary cholangitis (PBC) is a chronic, progressive autoimmune disease whose natural course leads to hepatic cirrhosis and failure, with an eventual need for liver transplantation. Treatment with ursodeoxycholic acid delays disease progression, but unfortunately, many patients do not respond to therapy. Obeticholic acid has shown promise as adjuvant therapy for incomplete responders but may exacerbate symptoms or even allow disease progression. Fibrates have been investigated for PBC and have shown therapeutic promise. However, they have been linked to rare but potentially severe cases of liver injury. In this review, we present an overview of PBC along with current therapies approved by the U.S. Food and Drug Administration. The literature was reviewed on PubMed from August 2022 to November 2023. We also discuss fibrate efficacy, overall safety, and the rare cases of liver injury. In conclusion, overall, fibrates are a relatively safe and effective adjuvant treatment for PBC.

Rhabdomyosarcoma (RMS) is the most frequent soft tissue sarcoma in children and young adults. Rarely, a range of hematological presentations can occur in RMS with an unknown primary tumor site and bone marrow involvement. The clinical manifestations of RMS mimicking acute leukemia are most reported in alveolar RMS (ARMS), which is associated with poor prognosis. Paired-box (PAX) 5 is a frequently used B-lineage marker for the diagnosis of B-cell lymphoma. However, recent reports suggest that PAX5 is immunoreactive to several other malignant tumors, including ARMS but not embryonal RMS (ERMS). This cross-reaction further complicates the differential diagnosis between RMS and B-cell lymphoma/leukemia. Herein, we present a case of ERMS immunoreactive to PAX5 in a young woman with manifestations resembling high-grade B-cell lymphoma/leukemia. This is the first report of PAX5 immunoreactivity in ERMS. The key takeaway from this case is that when children and young adults present with hematological manifestations, differential diagnoses should include RMS in addition to high-grade lymphoma/leukemia. In contrast to the recurrent forkhead box O1 (FOXO1) gene rearrangement found in ARMS, ERMS does not have recurrent structural chromosomal rearrangements but rather has frequent chromosomal gains. Recently, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutation has been reported more frequently in ERMS than in ARMS. The present case demonstrated complex karyotype, C-myelocytomatosis oncogene (MYC) amplification, and a PIK3CA (H1047) mutation. Our findings contribute to the understanding of the molecular genetic profile of ERMS and could be valuable for developing potential targeted therapies.

The highly valued area of traditional medicine includes medicinal plants and the chemical compounds found in them that have therapeutic potential as effective remedies for a variety of health issues. However, with respect to their active compounds and therapeutic value, many medicinal plants from various environments fall under the category of being underexplored. Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), was initially presented in November 2019. It was eventually labeled a pandemic, with an alarming number of deaths (6.987 million) and is still active. Alternative therapies are receiving more attention as a means of improving immunity and managing symptoms over the long term, despite the well-established scientific community’s quick success in implementing COVID-19 vaccinations. As an alternative strategy for COVID-19 management, traditional medicine therapies that comprise medicinal plants and extracts, formulations, and bioactive metabolites are currently receiving much interest. The usefulness of these herbal medicine interventions to manage COVID-19 infection has been the subject of recent studies, which are discussed here. In conclusion, we propose using plant extracts and their formulations as an alternative approach to treat COVID-19. This review may also instigate the development of anti-SARS-CoV-2 prophylactics from the active phytochemicals of these extracts.

The appendix, while a small portion of the gastrointestinal tract, can give rise to a variety of tumors. Goblet cell adenocarcinoma is an amphicrine tumor with both glandular and neuroendocrine features, and a molecular profile different from that of neuroendocrine tumors and conventional appendiceal adenocarcinomas. Low-grade appendiceal mucinous neoplasm is a tumor with low-grade cytology and histological findings that can mimic other benign entities. Here, we present a case of goblet cell adenocarcinoma that was associated with a ruptured diverticulum mimicking low-grade appendiceal neoplasm, and we review the available literature on these tumors.

Obesity is a chronic metabolic disease associated with the development of several other diseases, including cancer. The present study aims to evaluate the eating habits, physical activity, and clinical profiles of colorectal cancer (CRC) patients with overweight/obesity.

A cross-sectional study was conducted with data collected from the medical records of patients diagnosed with CRC (n = 41) from June 2019 to June 2022. Additionally, a questionnaire (n = 35) was applied to gather information on eating habits and physical activity. The data were subdivided into two groups of CRC patients: eutrophic and overweight/obesity. The results were presented as frequency distribution in percentage (%), mean ± standard deviation, or median and interquartile range.

All patients presented adenocarcinoma-type; most were in stages 3 and 4 and underwent surgery and chemotherapy. The overweight/obesity group showed a higher prevalence of metastasis, recurrence, and death compared to the eutrophic group. Ninety-six percent of patients demonstrated the need to reevaluate their eating habits, and the overweight/obesity group presented a significantly lower consumption of vegetables. Walking was the most commonly practiced physical activity both before and after diagnosis. However, both groups experienced a reduction in physical activity after CRC diagnosis, especially in the overweight/obesity group, in which both the frequency (p = 0.001) and duration of physical activity (p = 0.0005) significantly decreased.

Overweight/obese individuals are associated with a worse clinical profile, which can be associated with unhealthy habits, low consumption of vegetables, and low physical activity.

Lymph node fine needle aspiration biopsy (FNAB) is a useful diagnostic tool in the initial evaluation of lymphadenopathy of unknown etiology. The World Health Organization (WHO) Reporting System for lymph node cytopathology comprises five categories: insufficient/inadequate/nondiagnostic, benign, atypical, suspicious for malignancy, and malignant. This review focuses on the diagnostic criteria for each category, including cytomorphology, ancillary studies, differential diagnosis, and associated risk of malignancy. Its primary goal is to standardize the reporting and interpretation of lymph node samples, minimizing interobserver variability among pathologists. By establishing clear guidelines and standardized terminology, this system improves communication between pathologists and clinicians, leading to enhanced consistency, accuracy, and patient care in lymph node specimen evaluation. The WHO Reporting System serves as a unified and reproducible framework for the precise categorization of lymph node aspirates, enabling better communication between cytopathologists and clinicians and ultimately facilitating more effective patient management.

Functional constipation (FC) and the overweight/obesity (O/O) association are controversial. This study aims to investigate the prevalence of O/O, demographics, and clinical characteristics between children with O/O and normal BMIs, and establish whether O/O constitutes a clinical subgroup.

Retrospective observational study of children/adolescents referred for evaluation of constipation. Inclusion criteria: age between 01–192 months; diagnosis of FC according to the Rome Criteria III-IV; Bristol Stool Form 1 or 2.

450 FC children/adolescents were divided into three subgroups. In total, 34.4% had O/O. The proportion of overweight/obese children increased four times in the 61–192 subgroup (43.1%). Evaluation of subgroups: There was no significant difference in family factors, and there was a high presence of straining and painful defecation in the three subgroups. Evaluating O/O and normal BMI within each subgroup showed no significant difference for most variables. The statistical analysis of the comparisons of bowel movement characteristics between the O/O and normal BMI groups within each subgroup established that the normal BMI group had a higher presence of straining on defecation, blood in stools, and scybalous stools. In comparing BMI z scores, they were higher in the normal BMI group within the 25–60 subgroup than the 61–192 subgroup (p < 0.01).

The proportion of overweight/obese children rises after five years old. There was no substantial difference in the clinical characteristics between overweight/obese and normal BMI children. However, the normal BMI group was more symptomatic than the O/O group. This study, therefore, does not document a distinct subgroup of O/O in FC, and probably no difference between developed and developing countries regarding FC and O/O.

Focal nodular hyperplasia is a benign tumor of the liver that is often found incidentally with imaging. The purpose of this review is to discuss the pathophysiology, rare complications that can occur due to these lesions, and management options. A literature review was performed on clinical trials and case reports involving focal nodular hyperplasia complications and management of these, as well as the proposed pathogenesis underlying these tumors. Although exposure to oral contraceptive pills and endogenous hormones have been thought to play a role in the development of these lesions, this has not been proven. Most recently, they are thought to arise as a consequence of a vascular anomaly causing alterations in the expression of angiopoietin genes. Complications are rare, but previous cases have reported associated pain, rupture and compression of nearby structures (hepatic vein, stomach, biliary system). Resection of focal nodular hyperplasia is not usually recommended. However, if there is associated pain with no other identifiable cause or presence of a large or growing lesion with risk of causing a complication, then surgical resection, radiofrequency ablation or arterial embolization should be considered.