In March 2010, rifaximin was approved by the Food and Drug Administration for the prevention of HE on the basis of this clinical trial.

The main question that remains unanswered after this important study is whether rifaximin can suffice as monotherapy because more than 90% of the patients were also on lactulose. Also, the efficacy of rifaximin in more severe cases of HE is unclear. The majority of the patients had a Model for End-Stage Liver Disease HDAC inhibitor score ≤ 19. The long-term effects of rifaximin on the gut flora are also not known. Two patients in the rifaximin group developed a Clostridium difficile infection that was not related to the antibiotic per se according to the authors. In summary, rifaximin is a promising advance in the treatment and

prevention of HE; additional trials are needed to fully establish the efficacy of this agent used alone or in combination for HE associated with cirrhosis. We hope that studies such as the Rifaximin in Chronic Hepatic Encephalopathy trial, which is currently underway, will answer some of these questions. “
“Background:  Colorectal adenoma and coronary artery disease (CAD) appear to share common risk factors, selleck inhibitor such as male gender, diabetes mellitus, smoking, and obesity. We investigated the relationship between colorectal adenoma and coronary atherosclerosis, as a risk factor for colorectal adenoma. Methods:  A cross-sectional study was conducted on Korean men who presented for a health check-up. The subjects were 488 men (217 colorectal adenoma and 271 normal colonoscopic findings) who underwent colonoscopy and coronary computed tomography angiography (CTA) on the same day as a screening examination. Advanced colonic lesion was defined as a presence of adenoma with medchemexpress villous component, high-grade dysplasia, and/or with size of ≥1 cm. CTA findings were classified as normal, mild (low-grade atherosclerosis or <50% stenosis), and significant CAD (≥50% stenosis). Abnormal CTA findings included mild and significant CAD. Results: 

Patients with abnormal CTA findings were more likely to have colorectal adenoma compared with those with normal CTA findings (P < 0.005). Furthermore, presence of advanced adenoma was significantly associated with significant CAD (P < 0.01). On multivariate analyses, abnormal CTA findings (OR = 1.66, 95% CI: 1.14–2.41, P < 0.01) and significant CAD (OR = 1.96, 95% CI: 1.15–3.35, P < 0.05) were found to be independent risk factors for colorectal adenoma after adjusting for age, current smoking, and metabolic syndrome. Conclusions:  In this study, in the population who underwent CTA and colonoscopy for health check-up, prevalence of colorectal adenoma was greater in subjects with low-grade coronary atherosclerosis or significant CAD. The presence of advanced adenoma was significantly associated with significant CAD. "
“Autoimmune hepatitis (AIH) is an immune-mediated necroinflammatory condition of the liver.