The reasons for this difference are likely the small number of dually infected subjects Small molecule library in their study and differences in the patient characteristics. In our study, most of the dually infected patients had lower serum HBV loads because HBV is usually acquired perinatally or in early infancy and is inhibited by a subsequent HCV superinfection.2-4 Further investigation will be required to elucidate the contribution of steatosis to fibrogenesis in patients with HBV-HCV dual infection. Chao-Hung Hung M.D.*, Chuan-Mo Lee M.D.*, Sheng-Nan Lu M.D., M.P.H., Ph.D.*, Jing-Houng Wang M.D.*, Chien-Hung Chen M.D., Ph.D.*, Tsung-Hui Hu M.D., Ph.D.*,

* Division of Hepatogastroenterology, Department of PD-1 inhibitor Internal Medicine, Chang Gung Memorial Hospital–Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan. “
“We investigated the patency rate of a biliary stent and the effects of ursodeoxycholic acid (UDCA) therapy and endoscopic sphincterotomy (EST) for difficult-to-remove common bile duct stones. A total of 63 endoscopic retrograde cholangiopancreatographies (ERCPs) were performed in 36 patients (mean age, 86.0 years; male–female, 17:19) for stenting. Among the 63 subjects, 28 were further treated with EST; 20, with UDCA therapy; and 43, without UDCA therapy. The mean patency time was significantly

longer in the UDCA treatment group (1,012 days) than in the “stent without UDCA” group (354 days; P = 0.0002; hazard ratio, 0.253). The mean patency time was significantly longer in the patients who had stent placement with EST (1074 days) than in those who had stent placement without EST (279 days; P = 0.001; hazard ratio, 0.439). The mean patency time was significantly longer in the patients who had stent placement with UDCA therapy Urease and EST (1211 days) than in the patients who had stent placement with either UDCA therapy or EST (425 days; P = 0.031; hazard ratio, 0.3292). The mean patency time was significantly longer in the

patients who had stent placement with either UDCA therapy or EST than in those who had stent placement without UDCA therapy or EST (263 days; P = 0.0465; hazard ratio, 0.5124). Biliary stenting combined with UDCA therapy and EST may be considered as an effective treatment method for cases of common bile duct stones in elderly patients that are difficult to remove. “
“Patients who develop extrapyramidal symptoms on a background of cirrhosis and portosystemic shunting (PSS) form a unique subset of so-called acquired hepatocerebral degeneration.[1] The syndrome is different from other forms of Parkinsonism that develop in patients without liver disease and rarely responds to standard treatments for hepatic encephalopathy (HE). Rifaximin is a nonabsorbable antibiotic which has recently been shown to be efficacious in the secondary prevention of recurrent HE.