Carmen Colaci

Neuroendocrine tumors (NETs) of the liver are a rare entity. NETs are often poorly recognized, with diagnostic difficulties and differential challenges between primary tumors of the liver and metastases from other organs, mainly from the gastrointestinal tract. Multidisciplinary and multi-technical diagnosis is mandatory to properly treat these tumors. This case describes the complex history and the treatment course of a 68-year-old man with a history of NET onset after liver transplantation. Liver transplantation is the treatment of choice for patients with advanced liver disease or acute liver failure, but careful pre- and post-transplant patient monitoring is required. Liver transplant patients receive immunosuppressive therapy, and donor livers should be screened to exclude potential malignancies. This clinical case, in addition to emphasizing the diagnostic and therapeutic difficulty of hepatic NET, underlines the role of post-transplant immunosuppressive therapy and pre-transplant screening, which includes a thorough evaluation of donor and recipient history, physical examination, and laboratory tests. Moreover, post-transplant immunosuppressive therapy is essential to maintain the viability of the transplanted organ, but it is not free from potential risks, including an increased risk of cancer. Therefore, close monitoring of therapy is necessary to optimize long-term results and the patient’s quality of life.

Background: Inflammatory bowel disease (IBD), encompassing ulcerative colitis and Crohn’s disease, is a heterogeneous chronic condition characterized by periods of relapse and remission. Ulcerative colitis involves inflammation of the colon and rectum mucosa, while Crohn’s disease causes deeper, transmural inflammation affecting all four gut layers from the mouth to the anus and can lead to complications such as fistulation. IBD significantly impacts patients’ physical and psychological well-being, thus reducing their quality of life (QoL). We aimed to evaluate the effectiveness of nursing intervention facilitated through telephone and email support in improving the quality of life (QoL) of Inflammatory Bowel Disease (IBD) patients. Methods: A pilot comparative observational design with pre-test and post-test assessments was employed, involving 50 participants assigned to either an intervention group (Group A, n = 26) or a control group (Group B, n = 24). Group A received regular telephone consultations and prompt email responses from trained nurses; Group B received standard care. Data were collected at baseline and six months post-intervention (T1) using the Patient-Reported Outcomes Measurement Information System (PROMIS^®) and Pittsburgh Sleep Quality Index. Results: Group A showed significant improvements in anxiety, depression, fatigue, and sleep quality, with p-values indicating the significance of these findings. Conclusions: Tailored nursing support via remote communication significantly benefits IBD patients by alleviating psychological distress and enhancing their overall well-being, underscoring the importance of integrating such interventions into standard IBD care practices.

Alcoholic liver disease (ALD) is a major cause of chronic liver disease. This term covers a broad spectrum of liver lesions, from simple steatosis to alcoholic hepatitis and cirrhosis. The pathogenesis of ALD is multifactorial and not fully elucidated due to complex mechanisms related to direct ethanol toxicity with subsequent hepatic and systemic inflammation. The accumulation of pro-inflammatory cytokines and the reduction of anti-inflammatory cytokines promote the development and progression of ALD. To date, there are no targeted therapies to counter the progression of chronic alcohol-related liver disease and prevent acute liver failure. Corticosteroids reduce mortality by acting on the hepatic-systemic inflammation. On the other hand, several studies analyzed the effect of inhibiting pro-inflammatory cytokines and stimulating anti-inflammatory cytokines as potential therapeutic targets in ALD. This narrative review aims to clarify the role of the main cytokines involved in the pathogenesis and treatment of ALD.

Alcoholic liver disease (ALD) is a major cause of chronic liver disease. This term covers a broad spectrum of liver lesions, from simple steatosis to alcoholic hepatitis and cirrhosis. The patho-genesis of ALD is multifactorial and not fully elucidated due to complex mechanisms related to direct ethanol toxicity with subsequent hepatic and systemic inflammation. The accumulation of pro-inflammatory cytokines and the reduction of anti-inflammatory cytokines promote the development and progression of ALD. To date, there are no targeted therapies to counteract disease progression and prevent acute liver failure. Corticosteroids reduce mortality by acting on the hepatic-systemic inflammation. On the other hand, several studies analyzed the effect of the inhibition of pro-inflammatory cytokines and the stimulation of anti-inflammatory cytokines as potential therapeutic targets in ALD. This narrative review aims to clarify the role of the cy-tokines in the pathogenesis and treatment of ALD.