Prevention,diagnostic evaluation,management and prognostic implications of liver disease in critically ill patients with COVID-19

Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2,broke out in December 2019 in Wuhan city of China and spread rapidly worldwide.Therefore,by March 2020,the World Health Organization declared the disease a global pandemic.Apart from the respiratory system,various other organs of the human body are also seriously affected by the virus.Liver injury in patients with a severe form of COVID-19 is estimated to be 14.8%-53.0%.Elevated levels of total bilirubin,aspartate aminotransferase and alanine aminotransferase and low levels of serum albumin and prealbumin are the main laboratory findings.Patients with pre-existing chronic liver disease and cirrhosis are much more prone to develop severe liver injury.This literature review presented the recent scientific findings regarding the pathophysiological mechanisms responsible for liver injury in critically ill patients with COVID-19,the various interactions between drugs used to treat the disease and the function of the liver and the specific tests providing the possibility of early diagnosis of severe liver injury in these patients.Moreover,it highlighted the burden that COVID-19 put on health systems worldwide and its effect on transplant programs and the care provided to critically ill patients in general and particularly to those with chronic liver disease.

Fecal DNA testing for colorectal cancer screening:molecular targets and perspectives

The early detection of colorectal cancer with effective screening is essential for reduction of cancer-specific mortality. The addition of fecal DNA testing in the armamentarium of screening methods already in clinical use launches a new era in the noninvasive part of colorectal cancer screening and emanates from a large number of previous and ongoing clinical investigations and technological advancements. In this review, we discuss the molecular rational and most important genetic alterations hallmarking the early colorectal carcinogenesis process. Also, representative DNA targets-markers and key aspects of their testing at the clinical level in comparison or/and association with other screening methods are described. Finally, a critical view of the strengths and limitations of fecal DNA tests is provided, along with anticipated barriers and suggestions for further exploitation of their use.

Gastroenterology and liver disease during COVID-19 and in anticipation of post-COVID-19 era: Current practice and future directions

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has emerged as a major threat to global public health.The virus causes the clinical syndrome known as coronavirus disease 2019(COVID-19),in which multiple organs can get affected.Apart from manifestations of the respiratory system,which predominate,its clinical presentation is frequently accompanied by symptoms of the gastrointestinal(GI)tract and liver abnormalities.The correlation of symptoms and abnormalities with disease severity is discussed,leading to ambiguous results from international literature.Moreover,the disease infects patients with coexisting liver and GI disorders affecting both their health status and the availability of healthcare services provided to them.The risk of transmission of the disease during aerosol-generating procedures has changed the diagnostic approach and follow-up algorithms for liver and GI diseases.For the safety of both doctors and patients,telemedicine and distant evaluation have become everyday practice,whereas several routines and emergency visits at outpatient and emergency departments have been postponed or delayed.Vaccination against SARS-CoV-2 is underway,providing hope to humanity and the expectation that the post-COVID-19 era is near.This review aims to update knowledge about the manifestations of COVID-19 related to liver and GI diseases and the effect of the pandemic on the diagnostic and therapeutic procedures for these diseases with a special focus on how current practices have changed and what changes will possibly remain in the future.

Neuroendocrine differentiation and the ubiquitinproteasome system in cancer:Partners or enemies?

Neuroendocrine(NE)differentiation of cancer and deregulation of the ubiquitin-proteasome system(UPS)are two processes that have been independently linked to the development of aggressive and treatment-resistant tumors.Striking data suggest a plausible interconnection between these two mechanisms,based on indirect evidence of neuropeptide-induced effects on UPS,reversed by proteasome inhibition and deubiquitinaselike properties of NE markers.Deciphering the model of their exact interactions is one of the keys to targeting the NE malignant phenotype more effectively.