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The effect of HAV superinfection on mortality and morbidity in patients with chronic HCV has long been debated. The cost of protecting all patients with chronic HCV infection is extremely high and new research casts further doubt as to whether the benefits of such a strategy outweigh the cost.
The prevalence of NAFLD continues to increase in conjunction with sedentary lifestyles and nutrient-poor, calorie-rich diets. Given the recognized risks associated with NAFLD, effective interventions for prevention and treatment of this disease are needed. Increased exercise duration and intensity has been evaluated as an important therapeutic intervention.
Traditional management of appendicitis with appendectomy is regarded as efficient and safe, but it is not free from associated morbidity and mortality. Results from a meta-analysis published in the BMJ suggest that initial nonsurgical treatment with antibiotics merits consideration in patients with early uncomplicated appendicitis.
NAFLD, cardiovascular disease (CVD) and chronic kidney disease (CKD) are thought to be linked. However, whether NAFLD is a marker of, or a causal risk factor for, CVD and CKD is unclear. In this Review, Enzo Bonora and Giovanni Targher discuss the key pitfalls and main certainties surrounding the associations between these diseases.
Hepatorenal syndrome (HRS) is a serious complication of advanced cirrhosis with ascites. Although rare, HRS used to be a fatal condition. Improvements in our understanding of its pathophysiology, and consequent new treatments, mean that this is no longer the case. In this Review, Florence Wong summarizes the latest advances in the definition, pathophysiology, diagnosis and treatment options for HRS.
Now in use for over a decade, video capsule endoscopy (VCE) has become an integral part of the management of gastrointestinal diseases. In this Review, Fisher and Hasler provide a timely update on the current status and progress of VCE, describing the devices currently in use, established indications and future developments for this technology.
The role ofIL28B in chronic HCV infection has been studied extensively since a series of genome-wide association studies linked the IL28B locus to response to HCV therapy. In this Review, the authors provide a summary of the role of IL28B in HCV infection, describing how IL28Bgenetics affect viral dynamics, host immune response to the virus and response to therapy.
Personalized medicine is a new framework for medical care that involves modelling and simulation of a disease on the basis of underlying mechanisms. In this article, David Whitcomb uses chronic pancreatitis and an example to outline the limitations of the 20thcentury framework for medical care and examines the advantages of personalized medicine.
