Inflammatory bowel diseases (IBDs), including Crohn’s disease (CD) and ulcerative colitis (UC), are chronic immune-mediated disorders characterized by mucosal injury, cycles of inflammation and repair, and tissue damage. Persistent inflammation accelerates epithelial turnover, generates oxidative and replication stress, and remodels the stromal niche, contributing to the risk of colorectal cancer (CRC). Systematic dysplasia surveillance remains essential. Cellular senescence has emerged as a unifying mechanism linking inflammation, impaired epithelial repair, fibrosis, and neoplasia. In UC, p16/p21 upregulation, telomere erosion, and loss of lamin B1 accumulate and adopt a senescence-associated secretory phenotype (SASP) that perpetuates barrier dysfunction. In CD, senescence within stem and stromal compartments limits regeneration, promotes pro-fibrotic remodeling, and sustains cycles of injury and repair via chronic SASP signaling. IBD prevalence continues to rise from environmental factors, dietary changes, antibiotic exposures, and gut microbiota alterations. Pathogenesis integrates genetic factors (e.g., NOD2, IL23R, HLA, and ATG16L1 mutations), environmental modifiers, dysbiosis characterized by loss of short-chain fatty-acid-producing Gram-positive bacteria and expansion of Proteobacteria, and a dysregulated immune system. Therapeutic strategies have shifted toward targeted biologics and small molecules to promote mucosal healing. In this review, we recapitulate the mechanistic axes of inflammation, oxidative stress, and senescence in IBD and then critically evaluate emerging targeted therapies. Topics include anti-TNFα, integrin blockade, IL-12/23 and IL-23 inhibition, JAK inhibitors, S1P receptor modulators, microRNA modulation, senomorphics, mesenchymal cell therapy, and microbiome interventions. We endorse biomarker-guided therapy and propose future directions to break the SASP-driven inflammatory loop and mitigate long-term carcinogenic risk.

Objective: To analyze the graft outcome after liver transplantation in Italy in the years 1995 to 2000. Methods: We performed a longitudinal study with follow-up at 3 months, 1 year, 3 years, and 5 years on 1987 liver grafts. The effect of several variables on graft survival was also analyzed. Results: Several variables affect graft survival: Donor and recipient older age, gender mismatching, prolonged cold ischemia time, acute hepatic necrosis, and retransplantation are reported to significantly affect liver graft survival. Donors older than 60 years show a relative risk of 1.59 (95% CI, 1.23–2.05) compared with donors with an age between 19 and 60 years; recipients older than 50 years show a relative risk of 1.29 (95% CI, 1.04–1.60) compared with recipients aged 19 to 50 years. A cold ischemia time of 12 hours or longer doubled the risk of failure (relative risk = 2.01, 95% CI, 1.36–2.96) compared with a cold ischemia time of less than 6 hours. Conclusions: The results show that the overall quality of liver transplantation in Italy is satisfying and comparable to the outcome reported by international registries. Follow-up studies on large numbers of liver transplants are useful to define predictors of outcome, and subsequently modify the criteria for organ allocation.

Background: Primary plantar hyperhidrosis is a disabling condition characterized by excessive plantar sweating and impaired quality of life. Lumbar sympathectomy is reserved for patients with symptoms refractory to conservative treatment, but minimally invasive techniques remain technically heterogeneous. This study describes a modified retroperitoneoscopic lumbar sympathectomy and reports its preliminary perioperative outcomes. Methods: A single-center case series included consecutive patients who underwent modified retroperitoneoscopic lumbar sympathectomy for primary plantar hyperhidrosis between June 2019 and May 2024. The technique combined ultrasound-guided retroperitoneal access, indocyanine green (ICG)-assisted creation of the retroperitoneal working space, and temporary selective clamping of the lumbar sympathetic trunk with an intraoperative assessment of plantar temperature and perfusion before definitive clipping. Results: Forty-five patients underwent 81 procedures, including 35 bilateral procedures (70 sides), 10 unilateral procedures, and one unilateral reoperation for recurrent symptoms. All patients resumed oral intake and ambulation on the day of surgery and were discharged within 24 h according to institutional protocol. No intraoperative or postoperative complications were observed and resolution of plantar sweating in subsequent follow-ups was achieved. Conclusions: Modified retroperitoneoscopic lumbar Sympathetic Chain Selective Clamping appears to be a feasible and safe technique for the surgical treatment of primary plantar hyperhidrosis. These technical refinements may facilitate retroperitoneal access and intraoperative confirmation of the target sympathetic level. Larger comparative studies with standardized outcomes and longer follow-up are needed to confirm the durability and clinical value of this approach.