6% had lung metastases. Next-generation sequencing (NGS) was used in 36.6% of cases and polymerase chain reaction (PCR) in 16.6% of cases. KRAS mutations were present in 83.3% of patients and NRAS mutations in 16.6% of patients. Survival could be assessed in 10 patients and the median was 21.1 months (about 30% lower than the survival in the general mCRC population). Conclusion The results of this systematic review suggest the need to design a cohort study (either prospective or retrospective) to better characterize the patients with concomitant RAS and BRAF mutations and to establish the optimal treatment for this rare situation.Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) prevalence has increased in the past two decades, resulting in a significant but under-recognised public health burden. This impacts the prevalence of advanced fibrosis, end-stage liver disease and associated extrahepatic manifestations. To understand the challenges in recognising patients with advanced fibrosis due to NASH and develop a standardised approach to screen these patients, the authors of this document provided their opinions and expertise from practice and published evidence to identify key challenges and current approaches for diagnosing NASH. The severity of liver fibrosis due to NASH is the main indicator of associated morbidity and mortality outcomes. Therefore, identifying patients with, or at risk of, advanced fibrosis due to NASH and linking them to appropriate care is critical. This can be challenging due to a lack of awareness of NASH among healthcare professionals and a lack of standardised protocols for identifying patients. Simple noninvasive tests may provide an opportunity to facilitate early identification of these patients. This article proposes a simple, universally applicable diagnostic algorithm for use in clinical practice, that includes sequential use of noninvasive tests, ideally a biological marker and an imaging technique, which may help to facilitate early diagnosis of these patients. In the opinion of the authors, early detection of advanced fibrosis is fundamental in the efforts to halt the progression of NASH and diagnostic algorithms may facilitate pre-emptive interventions to curtail the disease.Irritable bowel syndrome (IBS) is a heterogeneous and complex functional gastrointestinal disorder with a global prevalence of approximately 11% and high geographic variation. IBS encompasses various symptom clusters considered to reflect complex patho-etiological mechanisms, and effective treatment options are limited, with most medications targeting individual mechanisms and symptoms. Therefore, multi-targeted treatment is required. IBS is currently viewed as a disorder of disturbed gut-brain interactions with abnormalities at different sites along the gut-brain axis, including altered gastrointestinal motility, visceral hypersensitivity, increased intestinal permeability, and altered gut microbiota. All of these abnormalities represent individual targets for STW 5, a herbal preparation with nine different extracts indicated for the treatment of functional dyspepsia and IBS. As a multi-targeted medicinal drug, STW 5 possesses multiple pharmacodynamic effects. Several in vitro and in vivo studies have demonstrated STW 5 efficacy on numerous IBS patho-mechanisms targeting gastrointestinal smooth muscles, visceral afferent nerves, inflammation, gut permeability, and the gut microbiome.Aims Comparing the risk of abnormal liver function tests between severe and non-severe patients with coronavirus disease 2019 (COVID-19) by meta-analysis. Methods A literature search was conducted using the databases PubMed, Embase, and Cochrane Library. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using fixed- or random-effects models. Publication bias was detected by the Harbord test. Results We included 8 articles comprising 7,467 COVID-19 patients. When compared between severe and non-severe COVID-19 patients, the pooled ORs of elevated alanine aminotransferase, aspartate aminotransferase, total bilirubin, and lactate dehydrogenase levels were 2.35 (95% CI 1.38-3.98), 3.21 (95% CI 2.59-3.98), 1.87 (95% CI 1.32-2.65), and 4.83 (95% CI 2.90-8.05), respectively. Conclusions The severity of COVID-19 is associated with liver damage, and can be a risk factor for abnormal liver function tests.Background and aims Recent studies have suggested an association between periodontitis and nonalcoholic fatty liver disease (NAFLD) although the results were inconsistent. The current systematic review and meta- analysis was conducted with the aim to comprehensively investigate this possible association by identifying all relevant studies and combining their results together.  https://www.selleckchem.com/products/turi.html  Methods A comprehensive literature review was conducted utilizing the MEDLINE and EMBASE databases through December 2019 to identify all studies that compared the risk of NAFLD among patients with periodontitis to individuals without periodontitis. Effect estimates from each study were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird. Results A total of five studies with 27,703 participants fulfilled the eligibility criteria and were included in the meta-analysis. All five studies reported the magnitude of association between NAFLD and periodontitis that was diagnosed based on the periodontal pocket depth of > 3.5-4 mm. The pooled OR of unadjusted analysis was 1.48 (95%CI 1.15-1.89; I 2 92%). However, when adjusted results from the primary studies were used, pooled OR decreased to 1.13 and lost its statistical significance (95%CI 0.95-1.35; I 2 67%). Three studies reported the magnitude of association between NAFLD and periodontitis that was diagnosed based on a clinical attachment level of ≥ 3 mm. The pooled OR of unadjusted analysis was 1.13 (95%CI 1.07-1.20; I 2 0%). However, when adjusted results from the primary studied were used, pooled OR decreased to 1.08 and lost its statistical significance (95%CI 0.94-1.24; I 2 58%). Conclusions The study found a significant association between periodontitis and NAFLD. However, the association lost its significance when various metabolic parameters were adjusted, suggesting that those metabolic conditions, not periodontitis itself, were predisposing factors for NAFLD.