Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of death worldwide, and its global burden has increased significantly over the past few years. The incidence of pancreatic cancer has also increased in the United States, and most of this increase is attributed to the population’s aging process in addition to the rise in the prevalence of risk factors such as obesity, diabetes, smoking, and alcohol intake. Most patients with pancreatic cancer present with advanced unresectable or metastatic disease. Only a few patients present at an early stage with localized disease, and a multidisciplinary approach is required to maximize survival and outcomes. The surgical approach is an option for localized disease, and surgery’s safety and efficacy have also been improved in recent years due to the increasing use of minimally invasive surgical techniques. Moreover, systematic chemotherapy has also been used and has had a significant impact on survival. More recently, neoadjuvant therapy has been used for pancreatic cancer along with radiation therapy, optimizing survival among those patients. Targeted therapies have been introduced based on genetic testing in metastatic pancreatic cancer and have shown promising results. Moreover, immune checkpoint inhibitors and targeted agents such as PARP inhibitors and vaccines have emerged with optimal results in terms of survival. To conclude, pancreatic cancer is considered a disease with poor long-term survival; however, recent developments in pharmacotherapy have changed its treatment and have improved outcomes with improved survival. Our review summarizes ongoing therapeutic options for local and metastatic pancreatic cancer. It also summarizes new state-of-the-art therapies that have emerged or are in trials, which can change the pancreatic cancer treatment perspective.

Inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), represents a significant challenge in gastroenterology due to its chronic nature, unpredictable course, and impact on patients’ quality of life. The therapeutic landscape for IBD has evolved significantly with the advent of biologic agents targeting specific immune pathways. However, limitations, including partial efficacy, side effects, and development of resistance, highlight the ongoing need for innovative treatment approaches. This review explores emerging therapies in IBD, including novel biologics, small molecules, microbiome-based therapies, and gene and stem cell therapies. The article summarizes their mechanisms of action, clinical efficacy, safety profiles, and potential future directions in IBD management. Methods: This comprehensive narrative review synthesizes current knowledge and emerging developments in inflammatory bowel disease (IBD) therapeutics. Literature was identified through targeted selection of high-quality sources, including pivotal randomized controlled trials, systematic reviews and meta-analyses, regulatory approval documents, and clinical practice guidelines from major gastroenterology societies. Emphasis was placed on recent publications (2020–2024) to capture the rapidly evolving therapeutic landscape, with particular attention to FDA/EMA-approved therapies and promising late-stage investigational agents. Sources were prioritized based on clinical relevance, study quality, and regulatory status. This narrative approach was selected to provide comprehensive coverage of diverse therapeutic modalities spanning conventional treatments to cutting-edge techniques, including biologics, small molecules, microbiome-based therapies, gene therapy, and stem cell treatments. The review acknowledges the inherent limitations of non-systematic literature selection while prioritizing clinical utility and educational value for healthcare providers managing IBD patients in contemporary practice.

Introduction Colorectal cancer (CRC) remains a leading cause of cancer-related mortality in the United States. While overall mortality has declined due to improvements in screening and treatment, persistent disparities by race, sex, and geography raise concerns about equitable healthcare access. Objective The objective of the study is to assess long-term trends in CRC mortality in the United States from 2000 to 2020, with a focus on racial, sex-based, and geographic disparities. Materials and methods A retrospective observational study was conducted using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. CRC mortality was identified using International Classification of Diseases, 10th Revision (ICD-10) codes C18-C21. Data were stratified by race, sex, and U.S. state. Age-adjusted death rates per 100,000 population were calculated and averaged over the 20-year period. Poisson regression analysis was conducted to assess the independent association of race and sex with mortality. Results were visualized by subgroup and geographic distribution. Results Black men had the highest national CRC mortality rate (17.7/100,000), followed by White men (15.3/100,000). Men consistently experienced higher mortality than women across all racial groups. Asian/Pacific Islander and American Indian or Alaska Native (AI/AN) populations had the lowest age-adjusted rates. Southern and Midwestern states demonstrated the highest average state-level mortality rates. Poisson regression confirmed that White (rate ratio (RR): 2.46), Black (RR: 2.24), and Asian (RR: 1.13) individuals had higher mortality than AI/AN individuals. Men had 9.2% higher mortality than women (RR: 1.09). All results were statistically significant (p < 0.001). Conclusion Significant disparities in CRC mortality persist across racial, sex, and regional lines in the United States. Black men experience the highest age-adjusted mortality, and overall rates are consistently higher among men than women. States in the South and Midwest carry the greatest burden, underscoring the need for geographically targeted interventions. These findings highlight the urgency of expanding access to screening, addressing systemic inequities, and implementing risk-based public health strategies in underserved communities.

Neuroendocrine tumors (NETs) are epithelial neoplasms with neuroendocrine differentiation that can arise throughout the gastrointestinal tract, including the appendix. Appendiceal NETs are rare neoplasms that frequently present as or mimic acute appendicitis. We report the case of a 28-year-old male patient who presented with right lower quadrant abdominal pain and was found to have early acute appendicitis on imaging. He underwent laparoscopic appendectomy, and final histopathology revealed a 0.5 cm well-differentiated Grade 2 NET at the tip of the appendix. The tumor was confined to the submucosa, with negative margins and no lymphovascular invasion. Immunohistochemistry was positive for chromogranin and synaptophysin, and the Ki-67 proliferation index was approximately 5%. Given the tumor’s small size, complete resection, and absence of high-risk features, no further surgery was performed. The patient was referred to oncology for multidisciplinary follow-up. This case highlights the importance of histologic grading and proliferation index in the postoperative evaluation of appendiceal NETs and supports the need for routine histopathologic analysis in all appendectomy specimens.

Background: Chronic liver disease (CLD), traditionally considered a condition of older adults, has shown increasing mortality in younger US adults. Rising rates of alcohol-related liver disease and metabolic dysfunction-associated steatotic liver disease (MASLD) have shifted the demographic profile of CLD burden. Objective: This study aimed to identify significant trends and disparities in CLD mortality among US adults aged 25-44 years from 2000 to 2020, with analysis stratified by age subgroup, sex, and race/ethnicity. Materials and methods: We conducted a retrospective analysis using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Underlying Cause of Death database. Deaths attributed to CLD were identified using International Classification of Diseases 10th Revision (ICD-10) codes K70 (alcoholic liver disease), K73 (chronic hepatitis), and K74 (fibrosis and cirrhosis). Data were stratified by age (25-34 and 35-44), sex, and race. Crude death rates per 100,000 were calculated. One-way analysis of variance (ANOVA) was performed to evaluate racial disparities within subgroups. Results: CLD mortality increased in all subgroups from 2000 to 2020. The highest rates were observed among men aged 35-44, particularly American Indian or Alaska Native (AI/AN) men, who reached an average of 19.4 deaths per 100,000. Black men and Hispanic women also experienced significant increases. ANOVA confirmed statistically significant racial disparities (p<0.0001) within all sex and age groups. Conclusion: CLD mortality is rising among young US adults, with disproportionately high rates in AI/AN and Black populations. These findings underscore the need for earlier screening, expanded public health interventions, and targeted support for underserved communities.

Introduction Upper gastrointestinal bleeding (UGIB) remains a significant cause of emergency department visits and hospitalizations across the United States. Despite advances in diagnostic and therapeutic modalities, mortality rates from UGIB continue to show marked variation across racial and geographic lines. Timely access to emergency endoscopic intervention is a critical determinant of outcomes, yet disparities in healthcare access and delivery may contribute to differential mortality. Methods We conducted a retrospective cross-sectional analysis using mortality data from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database spanning 2018 to 2023. Data were stratified by state, race, and demographic subgroup. The analysis encompassed 60 state-race combinations across 51 states, totaling a population of 522,663,547 individuals from three racial groups: White, Black/African American, and Asian. Primary outcomes included total UGIB-related deaths and population-adjusted crude mortality rates, expressed as deaths per 100,000 population. States were grouped into US Census Bureau-defined regions for geographic analysis. We calculated both weighted and unweighted mean mortality rates and assessed disparities using population-adjusted mortality ratios. Results A total of 133,477 UGIB-related deaths were identified, yielding a national crude mortality rate of 25.54 per 100,000 population. Racial disparities were significant, with Black/African American populations exhibiting the highest mortality rate at 46.22 per 100,000 (mortality ratio 1.86 compared to White populations, 95% CI: 1.82-1.90). White populations showed a mortality rate of 24.89 per 100,000, while Asian populations had a rate of 29.15 per 100,000. Geographic variation was notable, with mortality among White populations ranging from 22.07 per 100,000 in California to 158.79 per 100,000 in Maine. Regional analysis revealed that the West had the lowest overall mortality rate at 21.27 per 100,000, while the Midwest demonstrated the most pronounced racial disparities, with mortality rates of 67.85 per 100,000 among Black populations and 27.65 per 100,000 among Whites. Conclusion Substantial racial and geographic disparities exist in UGIB-related mortality across the United States. Black Americans face nearly double the mortality risk of White Americans, and a greater-than-seven-fold variation in state-level mortality among White populations underscores systemic differences in emergency endoscopic access and care quality. These findings support the urgent need for targeted policy and health system interventions to improve timely access to emergency endoscopic services, especially in high-mortality regions and underserved racial communities.