An extremely rare case of lesser omental hernia in an elderly female patient following total colectomy

BACKGROUND

An intro-abdominal hernia through the lesser omentum is a rare but severe condition that can cause intestinal obstruction and other life-threating complications. Until now, only a handful of cases have been reported worldwide. The diagnosis of lesser omental hernia remains challenging for emergency surgeons because of the unspecific symptoms. Therefore, there is a need for a better understanding of the characteristics of this condition.

CASE PRESENTATION

In this report, we described the case of a 73-year-old female patient who was diagnosed with a lesser omental hernia caused by previous total colectomy. The patient underwent emergency surgery, and the intraoperative findings revealed a 200-cm segment of the small intestine was herniated through a defected lesser omentum (approximately 3 × 4 cm) from the lesser retrogastric curvature of the stomach. Besides, we summarize the specific abdominal computed tomography (CT) findings of lesser omental hernia by reviewing the literature.

CONCLUSION

The lesser omental hernia is extremely rare but can cause serious complications. The cause of lesser omental hernia can be congenital or acquired. Careful examination of the small omentum before the closure of the abdomen is expected to reduce the occurrence of these abdominal surgery-associated complications. The specific features of abdominal CT in cases of lesser omental hernia, which are summarized in this article, can help other clinicians to obtain accurate diagnoses of lesser omentum hernia in the future.

Neurocutaneous melanosis with an intracranial cystic-solid meningeal melanoma in an adult: A case report and review of literature

BACKGROUND

Neurocutaneous melanosis (NCM) is a rare congenital, nonhereditary neurocutaneous syndrome that mainly occurs in children; adult NCM is very rare. Due to its rarity, the clinical features and treatment strategies for NCM remain unclear. The purpose of this study was to explore the clinical features, diagnosis, treatment and prognosis of NCM in adults. Most intracranial meningeal melanomas are solid masses, and cystic-solid malignant melanomas are very rare. Due to the lack of data, the cause of cystic changes and the effect on prognosis are unknown.

CASE SUMMARY

A 41-year-old woman was admitted to the hospital with intermittent headache for 1 mo. Magnetic resonance imaging (MRI) showed a 4.7 cm × 3.6 cm cystic-solid mass in the left temporal lobe with peritumoral edema. The entire mass was removed, and postoperative pathology indicated malignant melanoma.

CONCLUSION

MRI is the first-choice imaging approach for diagnosing central nervous system diseases in NCM patients, although cerebrospinal fluid may also be used. At present, there is no optimal treatment plan; gross total resection combined with BRAF inhibitors and MEK inhibitors might be the most beneficial treatment.

The relationship between the serum lipid profile and hepatocellular carcinoma in east Asian population: A mendelian randomization study

BACKGROUND

Although several studies have found that the serum lipid profile may be correlated with hepatocellular carcinoma (HCC), the causal relationships between the serum lipid profile and HCC have not been determined due to potential confounder. Here, Mendelian randomization (MR) analysis was performed to identify the relationship between the serum lipid profile and HCC in the East Asian population.

METHOD

Our study made a MR analysis with the validation of two data sets. We obtained genome-wide association study (GWAS) data related to the serum lipid profile from Asian Genetic Epidemiology Network (AGEN). Then, the data from a recent large GWAS of the East Asian ancestry in Japan (BioBank Japan, BBJ) were extracted. Summary-level statistical data for HCC were obtained from a large GWAS of the East Asian ancestry in Japan. Univariable MR analysis were performed to identify whether the genetic evidence of serum lipid profile was significantly associated with HCC risk. Multivariable MR analysis was conducted to estimate the independent effects of exposures on HCC.

RESULTS

Univariable and multivariable MR analyses indicated that the serum lipid profile was not a risk factor for HCC incidence in either data set based on the East Asian population. Multivariable MR analysis revealed that the hazard ratios of the probability of HCC in AGEN were 1.134 (95% confidence interval (CI), 0.903-1.424) for TG, 1.010 (95% CI: 0.824-1.237) for HDL-C, 0.974 (95% CI: 0.746-1.271) for TC, 0.918 (95% CI: 0.734-1.147) for LDL-C, while the results in BBJ were also non-significant: 1.111 (95% CI: 0.869-1.419) for TG, 0.957 (95% CI: 0.790-1.158) for HDL-C, 0.917 (95% CI: 0.643-1.308) for TC, 0.932 (95% CI: 0.699-1.243) for LDL-C.

CONCLUSION

Our MR study with the validation of two data sets found no strong evidence to support causal associations between the serum lipid profile and HCC risk.

The Prediction and Prognostic Significance of INPP5K Expression in Patients with Liver Cancer

Liver cancer is a devastating disease for humans with poor prognosis. Although the survival rate of patients with liver cancer has improved in the past decades, the recurrence and metastasis of liver cancer are still obstacles for us. Inositol polyphosphate-5-phosphatase K (INPP5K) belongs to the family of phosphoinositide 5-phosphatases (PI 5-phosphatases), which have been reported to be associated with cell migration, polarity, adhesion, and cell invasion, especially in cancers. However, there have been few studies on the correlation of INPP5K and liver cancer. In this study, we explored the prognostic significance of INPP5K in liver cancer through bioinformatics analysis of data collected from The Cancer Genome Atlas (TCGA) database. Chi-square and Fisher exact tests were used to evaluate the relationship between INPP5K expression and clinical characteristics. Our results showed that low INPP5K expression was correlated with poor outcomes in liver cancer patients. Univariate and multivariate Cox analyses demonstrated that low INPP5K mRNA expression played a significant role in shortening overall survival (OS) and relapse-free survival (RFS), which might serve as the useful biomarker and prognostic factor for liver cancer. In conclusion, low INPP5K mRNA expression is an independent risk factor for poor prognosis in liver cancer.

Outcomes of laparoscopic pancreaticoduodenectomy using a modified technique：346 cases from a single center

PURPOSE

To study the outcomes of laparoscopic pancreaticoduodenectomy (LPD) using a modified technique.

METHODS

Our center used priority approach of uncinate process and artery in the pancreatectomy and duct to mucosa pancreaticojejunostomy with a single stitch in the pancreaticojejunostomy. Herein, we retrospectively reviewed 346 cases of LPD using modified techniques. Basic characteristics, preoperative outcomes, factors associated with unfavorable postoperative outcome, and mortality of patients undergoing LPD were collected and analyzed.

RESULTS

The average operative time was 259.31 (35-425) min. The mean duration of pancreaticojejunostomy anastomosis was 31.97 (16-90) min. The mean intraoperative blood loss was 101.76 (0-1200) ml by estimation. Postoperative complications included 14 cases (4.1%) of bile leakage, 9 cases (2.6%) of delayed gastric emptying, 26 cases (7.5%) of postoperative bleeding, 34 cases (9.9%) of organ space infection, 17 cases (4.9%) of pulmonary infection, and 50 cases (14.5%) of POPF. Three factors including postoperative bleeding (OR = 3.502; P = 0.033), positive lymph node (OR = 3.296; P < 0.001), and postoperative chemotherapy (OR = 0.241; P = 0.008) were significantly associated with death of LPD.

CONCLUSIONS

The modified technique for LPD presents safety and reliability. Postoperative bleeding and positive lymph node may be associated with worse overall survival, and postoperative chemotherapy may be associated with better overall survival.

LncRNA HOTAIR Enhances Epithelial-to-mesenchymal Transition to Promote the Migration and Invasion of Liver Cancer by Regulating NUAK1 via Epigenetic Inhibition miR-145-5p Expression

LncRNA HOTAIR play important roles in the epigenetic regulation of carcinogenesis and progression in liver cancer. Previous studies suggest that the overexpression of HOTAIR predicts poor prognosis. In this study, through transcriptome sequencing data and in vitro experiments, we found that HOTAIR were more highly expressed and there is significantly positive relationship between HOTAIR and NUAK1 in liver cancer tissues and cell lines. miR-145-5p was downregulated and showed negative correlation with HOTAIR and NUAK1. Transfect Sh-HOTAIR, LZRS-HOTAIR, miR-145 mimic, miR-145 inhibitor to change the expression of HOTAIR and miR-145-5p. The addition of HTH-01-015 inhibits the expression of NUAK1. HOTAIR knockdown, miR-145-5p upregulation and NUAK1 inhibition all repressed migration, invasion and metastasis and reversed the epithelial-to-mesenchymal transition in SNU-387 and HepG2 cells. We also showed that HOTAIR recruiting and binding PRC2 (EZH2) epigenetically represses miR-145-5p, which controls the target NUAK1, thus contributing to liver cancer cell-EMT process and accelerating tumor metastasis. Moreover, it is demonstrated that HOTAIR crosstalk with miR-145-5p/NUAK1 during epigenetic regulation. Our findings indicate that HOTAIR/miR-145-5p/NUAK1 axis acts as an EMT regulator and may be candidate prognostic biomarker and targets for new therapies in liver cancer.

Risk and management of adverse events in minimally invasive esophagectomy

Minimally invasive esophagectomy (MIE) has transformed esophageal surgery by reducing morbidity, accelerating recovery, and improving postoperative outcomes compared to traditional open esophagectomy. By utilizing techniques such as laparoscopic, thoracoscopic, and robotic-assisted approaches, MIE minimizes surgical trauma while maintaining oncological thoroughness. However, it also presents unique challenges, including risks of complications such as anastomotic leakage, pulmonary complications, and atrial fibrillation. Zhong et al developed and validated a risk stratification model for predicting surgical adverse events after MIE, enhancing preoperative assessment and patient management. This editorial further examines the advantages of MIE, its comparable oncological and long-term outcomes, as well as the incidence and contributing factors of postoperative complications. Emerging technologies, including machine learning models, intraoperative nerve monitoring, and robotic-assisted surgery, are highlighted as innovative solutions for risk prediction and prevention. Strategies such as enhanced recovery after surgery protocols and multidisciplinary collaboration are emphasized for their critical roles in minimizing complications and optimizing patient outcomes. By addressing these aspects, this editorial provides guidance to surgical teams in maximizing the benefits of MIE while effectively managing its associated risks.

Long non-coding RNA HOTAIR promotes tumourigenesis by affecting proliferation, invasion, migration, and apoptosis of liver cancer cells

INTRODUCTION

Increasing evidence shows that Hox transcript antisense RNA (HOTAIR) plays a vital role in liver cancer initiation and progression by affecting the proliferation, invasion, migration, and apoptosis of liver cancer cells. However, the underlying mechanism of how HOTAIR exerts its functions in liver cancer cells remains unclear. Previous studies have shown that HOTAIR affects the invasion and migration of liver cancer cells by regulating the expression of E-cadherin. Snail2, a transcription factor involved in epithelial-mesenchymal transition, directly binds to the E-boxes of the E-cadherin promoter to repress its transcription. The aim of the study was to examine the correlation between HOTAIR and Snail2 in the HOTAIR/Snail2/E-cadherin signal pathway and explore the role of HOTAIR in the proliferation, invasion, migration, and apoptosis of liver cancer cells.

MATERIALS AND METHODS

Fifty matched normal liver tissues and 373 liver cancer tissues were analysed and evaluated. HepG2 and SNU-387 cells were cultured and transfected with plasmids knocking down HOTAIR to disrupt HOTAIR expression. Cell scratch and transwell assays were performed to examine the migration and invasion of HepG2 and SNU-387 cells; in addition, the expression of MMP2 and MMP9 was detected by immunoblotting analysis, RT-qPCR analysis, immunofluorescence analysis, and bioinformatics analysis, which elucidated the regulatory relationship between HOTAIR and Snail2. We used flow cytometry and JC-1 probe analysis assays to clarify the function of HOTAIR inliver cancer cell apoptosis.

RESULTS

The HOTAIR mRNA was upregulated in liver cancer tissues, which was related to worse overall survival. HOTAIR induced the expression of matrix metalloproteinase-9 (MMP9) and metalloproteinase-2 (MMP2), leading to degradation of extracellular matrix. HOTAIR knockdown significantly reduced the doubling time and inhibited cell migration and invasion of liver cancer cells. Furthermore, HOTAIR depletion induced mitochondrial-related apoptosis in HepG2 and SNU-387 cell lines.

CONCLUSIONS

In this study, we propose a novel mechanism in which HOTAIR promotes invasion and migration of liver cancer cells by regulating the nuclear localisation of Snail2.

Association Between Serum Levels of Perfluoroalkyl and Polyfluoroalkyl Substances and Dental Floss Use: The Double-Edged Sword of Dental Floss Use-A Cross-Sectional Study

BACKGROUND

Although evidence suggests that dental floss contains perfluoroalkyl and polyfluoroalkyl substances (PFASs), it is still uncertain whether the use of dental floss contributes to an increased risk of PFAS exposure.

METHODS

We analysed data on serum PFAS concentrations and dental floss usage in a cohort of 6750 adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2020. In our study, we used logistic regression, a survey-weighted linear model, item response theory (IRT) scores, inverse probability weights (IPWs) and sensitivity analysis to assess the potential impact of dental floss usage on human serum PFAS levels.

RESULTS

The analysis of six PFASs revealed that dental floss users had higher serum concentrations of perfluorooctanoic acid (PFOA) compared with non-users, while serum concentrations of other PFASs were lower. Dental floss users recorded a lower level of overall PFAS burden score compared with non-users. Sensitivity analysis showed a statistically significant increase in serum PFOA concentration among dental floss users.

CONCLUSION

Our findings suggest that the use of dental floss may be associated differently with serum concentrations of specific PFASs. Among a large representative sample of U.S. adults, individuals reporting the use of dental floss had lower levels of serum PFASs overall, with the exception of PFOA, which was slightly elevated. Dental floss is an important oral hygiene tool, and further research is needed to clarify its role in PFAS exposure.

Cysteine conjugate beta-lyase 2 (CCBL2) expression as a prognostic marker of survival in breast cancer patients

OBJECTIVE

Cysteine conjugate beta-lyase 2 (CCBL2), also known as kynurenine aminotransferase 3 (KAT3) or glutamine transaminase L (GTL), plays an essential role in transamination and cytochrome P450. Its correlation with some other cancers has been explored, but breast cancer (BC) not yet.

METHODS

The mRNA and protein expression of CCBL2 in BC cell lines and patient samples were detected by RT-qPCR and immunohistochemistry (IHC). BC patients' clinical information and RNA-Seq expression were acquired via The Cancer Genome Atlas (TCGA) database. Patients were categorized into high/low CCBL2 expression groups based on the optimal cutoff value (8.973) determined by receiver operating characteristic (ROC) curve. We investigated CCBL2 and clinicopathological characteristics' relationship using Chi-square tests, estimated diagnostic capacity using ROC curves and drew survival curves using Kaplan-Meier estimate. We compared survival differences using Cox regression and externally validated using Gene Expression Omnibus (GEO) database. We evaluated enriched signaling pathways using gene set enrichment analysis (GSEA), explored CCBL2 and relevant genes' relationship using tumor immunoassay resource (TIMER) databases and used the human protein atlas (HPA) for pan-cancer analysis and IHC.

RESULTS

CCBL2 was overexpressed in normal human cell lines and tissues. CCBL2 expression was lower in BC tissues (n = 1104) than in normal tissues (n = 114), validated by GEO database. Several clinicopathologic features were related to CCBL2, especially estrogen receptor (ER), progesterone receptor (PR) and clinical stages. The low expression group exhibited poor survival. CCBL2's area under curve (AUC) analysis showed finite diagnostic capacity. Multivariate cox-regression analysis indicated CCBL2 independently predicted BC survival. GSEA showed enriched pathways: early estrogen response, MYC and so on. CCBL2 positively correlated with estrogen, progesterone and androgen receptors. CCBL2 was downregulated in most cancers and was associated with their survival, including renal and ovarian cancers.

CONCLUSIONS

Low CCBL2 expression is a promising poor BC survival independent prognostic marker.

The Pandora's Box of Bariatric Surgery: Unveiling the Association with Kidney Stone Risk-A Cross-Sectional Study

BACKGROUND

Metabolic and bariatric surgery is an effective intervention for severe obesity, known for improving comorbidities such as type 2 diabetes, hypertension, and hyperlipidemia. However, its association with kidney stone formation remains uncertain. This study investigates the relationship between bariatric surgery and kidney stone prevalence using data from NHANES 2015-2018.

METHODS

We conducted a cross-sectional analysis of 8,087 participants from NHANES (2015-2018). Bariatric surgery and kidney stone history were self-reported. Logistic regression models adjusted for demographic, clinical, and lifestyle factors were used to evaluate associations. Stratified analyses explored effect modification by subgroups.

RESULTS

Kidney stones were more prevalent among participants with bariatric surgery (26.57%) compared to those without (10.92%, P < 0.001). Bariatric surgery was associated with increased odds of kidney stones in the crude model (OR: 2.95, 95% CI: 1.57-5.55) and adjusted models (OR: 2.69, 95% CI: 1.27-5.70). Subgroup analyses highlighted stronger associations among females and participants with moderate physical activity.

CONCLUSION

Metabolic and bariatric surgery is linked to an elevated risk of kidney stones, influenced by demographic and clinical factors. Personalized counseling on hydration and dietary modifications is essential for mitigating this risk.

Undifferentiated embryonal sarcoma of the liver with epithelioid features in an adult patient: A case report

INTRODUCTION

Undifferentiated embryonal sarcoma of the liver (UESL) is a rare form of liver malignancy, with most cases reported in the pediatric population. This disease is extremely uncommon in adults. Herein, we report the first case of UESL with epithelioid features in an adult patient.

PATIENT CONCERNS

A 50-year-old man was admitted to our hospital due to epigastric pain.

DIAGNOSIS AND INTERVENTIONS

Computed tomography and magnetic resonance imaging revealed a space-occupying lesion in the right lobe of the liver. A right hemihepatectomy was performed. Postoperative pathological and immunohistochemical examinations confirmed the diagnosis of UESL and features of epithelioid differentiation.

OUTCOMES

The patient recovered well and refused adjuvant therapy. Unfortunately, the patient died of tumor recurrence 3 months after hospital discharge.

CONCLUSION

UESL is a rare form of liver cancer, with most cases reported in the pediatric population. This case study highlights an extremely uncommon case of UESL with epithelioid features and a very poor prognosis. The findings suggest that complete intraoperative resection and postoperative adjuvant therapy should be considered to improve the prognosis of adult patients with UESL with epithelioid features.

Biomaterial-based drug delivery: evaluating the safety profiles of liposomal Vyxeos

Vyxeos, a liposomal combination of cytarabine and daunorubicin, has improved survival outcomes for patients with high-risk acute myeloid leukemia (AML). However, its safety profile in real-world settings requires comprehensive evaluation. This study aims to assess the adverse event profiles associated with Vyxeos using data from the U.S. FDA's Adverse Event Reporting System (FAERS). A retrospective analysis of adverse event reports from the FAERS database was conducted for Vyxeos from January 2017 to June 2024. Reports were analyzed to assess patient demographics, system organ classes (SOCs), and preferred terms (PTs). Signal detection analysis was performed using disproportionality metrics, including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS). A total of 1,036 reports were analyzed. The most frequently reported adverse events were hematologic (37.73%), infectious (28.42%), and cardiac disorders (13.22%). Febrile neutropenia, neutropenic sepsis, and pneumonia fungal were the most commonly reported events, with febrile neutropenia showing a strong association (ROR = 92.18). Males had a higher frequency of infectious events, while females reported more cardiac events. Most adverse events occurred within 30 days of treatment initiation, and 16.92% of reports involved hospitalization, while 18.33% reported death. Vyxeos is associated with significant hematologic, infectious, and cardiac adverse events. Close monitoring, infection prophylaxis, and cardiac assessments are recommended for patients receiving Vyxeos. Further research is needed to validate these findings and explore the mechanisms underlying the observed toxicities.

[Corrigendum] Rab22a is a novel prognostic marker for cell progression in breast cancer

Following the publication of this article, the authors have realized that Table I contained an error: The number of patients who were alive in the Rab22a high expression group should have been written as 77 instead of 772.
A corrected version of the Table is shown on the next page (the corrected datum is highlighted in bold). The authors sincerely apologize for the error that was introduced during the preparation of this Table, and regret any inconvenience that this mistake has caused. [the original article was published in International Journal of Molecular Medicine 45: 1037-1046, 2020; DOI: 10.3892/ijmm.2020.4486].

Exploring the dark side of diagnostic dyes with a focus on Indocyanine green's adverse reactions

Indocyanine green (ICG) is a diagnostic dye commonly used in medical imaging and liver function monitoring. Given its widespread use, there is a need for detailed evaluations of its adverse drug reactions in real-world settings. As the comprehensive overview of its safety profile is very limited, this study aimed to analyze the adverse events (AEs) associated with ICG using data from the Food and Drug Administration Adverse Event Reporting System (FAERS). Data between 2004Q1 and 2023Q4 were extracted from the FAERS database. Signal detection was performed using various disproportionality analysis algorithms, including reporting odds ratio (ROR), proportional reporting ratio, Bayesian confidence propagation neural network, and multiitem gamma Poisson shrinker. During the study period, a total of 62 ICG-related AEs were reported in the FAERS database. Significant clinical adverse reactions included anaphylactic shock (ROR: 92.10, 95% confidence interval (CI): 37.71-224.96), procedural hypotension (ROR: 1397.27, 95% CI: 443.31-4404.08), and urticaria (ROR: 10.88, 95% CI: 4.02-29.42). This study provides valuable insights into the safety profile of ICG, highlighting the need for further monitoring to ensure its safe clinical use in clinical practice. Ongoing pharmacovigilance and large-scale studies are warranted to fully understand the potential risks associated with ICG.

Mendelian randomization study on the causal relationship between food and cholelithiasis

BACKGROUND

Cholelithiasis, commonly referred to as gallstones, is a prevalent medical condition influenced by a combination of genetic factors, lifestyle choices, and dietary habits. Specific food items have been associated with an increased susceptibility to cholelithiasis, whereas others seem to offer a protective effect against its development.

METHODS

In this study, we conducted a Mendelian randomization (MR) analysis using a large-scale genetic dataset comprising individuals with European ancestry to explore the potential causal relationship between diet and cholelithiasis. The analysis incorporated 17 food-related variables, which were considered as potential factors influencing the occurrence of this condition.

RESULTS

Our findings indicate that a higher consumption of cooked vegetables, dried fruit, and oily fish is associated with a reduced risk of cholelithiasis. Conversely, a higher consumption of lamb is associated with an increased risk of developing the condition. Importantly, these associations proved robust to sensitivity and heterogeneity tests, and the pleiotropic test results further supported the hypothesis of a causal relationship between diet and cholelithiasis.

CONCLUSION

Through our study, we provide compelling evidence for the existence of a causal relationship between diet and cholelithiasis. Adopting a dietary pattern enriched with cooked vegetables, dried fruit, and oily fish, while minimizing lamb intake, may contribute to the prevention of cholelithiasis. Recognizing diet as a modifiable risk factor in the prevention and management of this condition is of paramount importance, and our study offers valuable insights in this regard.

Unveiling the Hidden Risks: An Update Decade-Long Analysis of Abraxane-Related Adverse Events from the FAERS Database

PURPOSE

Abraxane (nanoparticle albumin-bound paclitaxel) is a chemotherapeutic employed commonly for the management of various cancers including breast cancer, non-small cell lung cancer, and pancreatic adenocarcinoma. Although it has clinically beneficial properties, Abraxane is accompanied by multiple adverse events (AEs) that require close observation. This study aims to evaluate the AE profile of Abraxane using recently available data from January 2004 through December 2023 in the FDA Adverse Event Reporting System (FAERS).

PATIENTS AND METHODS

The data for Abraxane-related AEs were obtained from the FAERS database. The dataset consisted of patient demographic characteristics as well as information on the types and outcomes of AEs reported. Reporting odds ratios (ROR) as well as proportional reporting ratio (PRR), considering the used definition of anti-cancer agent and AEs, were calculated to investigate any association with Abraxane.

RESULTS

A total of 10,310 reports associated with Abraxane AEs were identified. Blood and lymphatic system disorders were the most frequent (ROR 6.44), followed by hepatobiliary (ROR 3.16), infections (ROR 1.45), and gastrointestinal disorders (ROR 1.42). Serious outcomes included hospitalization in 36.35% and death in 29.76% of cases. The top adverse reactions matched known profiles, including peripheral sensory neuropathy (ROR: 49.48). The analysis also found new adverse reactions, such as scleroderma-like reactions (ROR: 95.4) and vascular pseudoaneurysm ruptures (ROR: 87.71).

CONCLUSION

Our results re-emphasize the importance of a robust Post Marketing Surveillance system and suggest this FAERS database based analysis provides an updated, independent information on Abraxane related AEs to enrich its safety profile. A process of continuous vigilance and additional investigations on specific areas that may have some undesired events are imperative to increase our knowledge on how Abraxane should be handled in terms of its safety.

Genetic and environmental factors influencing Crohn's disease

This editorial discusses Pellegrino and Gravina's essay. Crohn's disease (CD) is a complex and multifactorial disease that is influenced by a combination of genetic and environmental factors. While genetic factors play a key role in the development of the disease, environmental factors also play a significant role in influencing the risk of developing CD. By looking at present understanding of CD pathogenesis, we emphasize the important factors involved in the development of this illness, such as nucleotide-binding oligomerization domain-2, smoking, and vitamin D. Understanding the interplay between genetic and environmental factors is crucial for developing effective strategies for preventing and treating this chronic inflammatory bowel disease.