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The optimal treatment for classic Whipple disease has not yet been determined. A recent study reported encouraging results for initial treatment with intravenous ceftriaxone or meropenem followed by long-term treatment with oral trimethoprim–sulfamethoxazole. However, discrepancies in the failure and/or relapse rates associated with trimethoprim–sulfamethoxazole show that this regimen may not be optimal.
Insulin sensitizing agents, such as the thiazolidinediones pioglitazone and rosiglitazone, have been used in clinical trials for the treatment of nonalcoholic steatohepatitis, a common form of liver disease that is associated with insulin resistance. The results of these trials have been variable, suggesting that a deeper understanding of other contributing factors to the development of nonalcoholic steatohepatitis is needed to establish whether improving adipose insulin sensitivity might be important.
Although a great deal is known about the environmental and genetic causes of colorectal cancer, it is still one of the most common cancers in the world. A new German study including >17,500 patients focuses on differences between proximal and distal disease. Is there anything new from this study that could help us further understand the etiology of colorectal cancer and improve the screening and management of this disease?
The need for mass screening of the general population for colorectal cancer is well established. However, there is no consensus on the best screening test. A recent study brings new data to clinicians and health authorities regarding the optimal test for colorectal cancer screening.
Hepatocyte transplantation has shown potential as an additional treatment modality for certain diseases of the liver, particularly liver-based metabolic disorders. The authors of this Review outline the current bench-to-beside experience with hepatocyte transplantation, and discuss the limitations that need to be overcome for its wider application.
Nonalcoholic fatty liver disease (NAFLD) is the most frequent liver disease worldwide, and is associated with the metabolic syndrome. This Review discusses the mechanisms involved in hepatic steatosis and inflammation—the two steps of liver injury in NAFLD. The authors also discuss the role of fructose in the development of both NAFLD and the metabolic syndrome.
The signaling pathways that are involved in the regulation of hypoxia in the intestinal epithelial barrier during active inflammatory diseases, such as IBD, are discussed by Sean Colgan and Cormac Taylor in this Review. The activation of hypoxia-inducible factor (HIF) promotes the resolution of inflammation in mouse models of disease and ways of stabilizing HIF to treat IBD are being sought.