Archives of Gastroenterology Research

A 67-year-old female with a history of arterial hypertension and previous hysterectomy, was recovered, in July 2019, for moderately-severe acute biliary pancreatitis with evidence of stones in gallbladder and bile duct and pancreatic necrosis on imaging (Magnetic Resonance Cholangiopancreatography. A contrast enhanced CT, a week after the admission, showed necrotic areas in the pancreas and a large peripancreatic fluid collection (60 mm long) with air pockets within (acute necrotic collection, with signs of infection. Since she was haemodynamically stable and there was no evidence of organ failure, according to “step-up approach”, she was managed medically with antibiotics (piperacillin-tazobactam + metronidazole) and fluids.

Gastric cancer (GC), also known as stomach cancer, is a worldwide health problem. Anatomically, it can occur from the gastroesophageal junction to distal portions of the stomach. Considering both sexes, worldwide, it is the 5th most common neoplasm (5.7%) and the 3rd cause of mortality among malignancies, leading to approximately 782,000 deaths in 2018. The incidence varies geographically but 50% of new cases are diagnosed in developed countries. High incidence is observed in Asia, Latin America, and in the central and eastern parts of Europe. There are several ways to classify GC, but the most used is Lauren’s Classification, which proposes two main histological groups: intestinal and diffuse. This classification is important because there are marked etiological, pathological, and epidemiological differences between the subgroups, guiding the clinical approach for each patient.

In pharmacologic doses niacin (nicotinic acid) has been used clinically for over six decades for atherogenic dyslipidemia and reduction of cardiovascular event risk. In combination with statin therapy, it effects regression of coronary atherosclerosis. Emerging evidence indicates a new potential use for niacin for the treatment of NAFLD and its complications. Despite this enormous amount of data on niacin, there is confusion and misconceptions about its use of a drug rather than as a vitamin, its formulations, and how it can be used in clinical practice. The purpose of this invited brief communication is to update and summarize this emerging evidence. We comment on how it may be valuable in the context of other drugs-in-development for NAFLD, especially for combination therapy for synergistic efficacy.

Although the prevalence of gastric cancer is decreasing in many developed nations, it is the fourth most prevalent cancer and the second leading cause of cancer-related deaths globally. Around 8 percent of recently diagnosed malignant tumors are stomach cancer, more than 7,00,000 individuals die from gastric cancer yearly. Despite extensive research into new diagnostic and therapeutic methods, the prognosis for individuals with advanced stomach cancer remains dismal, and survival rates have hardly improved. In recent years, many latest innovations have improved our understanding of the molecular mechanisms and modifications that contribute to gastric cancer’s beginning and progression, including several genetic and molecular modifications and mutations.