Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · Feb 2016
Review Meta AnalysisSystematic review with meta-analysis: long-term outcomes of faecal microbiota transplantation for Clostridium difficile infection.
Clostridium difficile infection is a major cause of nosocomial diarrhoea. ⋯ Faecal microbiota transplantation seems to be a highly effective and robust therapy for recurrent C. difficile infection. However, more quality studies, such as randomised controlled trials and cohort studies with control groups, are needed to confirm its long-term efficacy and safety.
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Aliment. Pharmacol. Ther. · Jan 2016
Randomized Controlled TrialSofosbuvir plus ribavirin for the treatment of patients with chronic genotype 1 or 6 hepatitis C virus infection in Hong Kong.
In Hong Kong, most patients with hepatitis C virus (HCV) have either genotype 6a or 1b infection. ⋯ The all-oral regimen sofosbuvir plus ribavirin is effective in treatment-naïve patients in Hong Kong with genotype 1 or 6 HCV.
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Aliment. Pharmacol. Ther. · Jan 2016
ReviewReview article: potential mechanisms of action of rifaximin in the management of irritable bowel syndrome with diarrhoea.
The role of gut microbiota in the pathophysiology of irritable bowel syndrome (IBS) is supported by various lines of evidence, including differences in mucosal and faecal microbiota between patients with IBS and healthy individuals, development of post-infectious IBS, and the efficacy of some probiotics and nonsystemic antibiotics (e.g. rifaximin). ⋯ Resetting microbial diversity via rifaximin use may lead to a decrease in bacterial fermentation and a reduction in the clinical symptoms of IBS.
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Aliment. Pharmacol. Ther. · Jan 2016
Non-invasive screening of diabetics in primary care for NAFLD and advanced fibrosis by MRI and MRE.
Current guidelines do not recommend screening for non-alcoholic fatty liver disease (NAFLD) or advanced fibrosis. Patients with type 2 diabetes mellitus (T2DM) are known to be at increased risk for NAFLD and advanced fibrosis. ⋯ This proof-of-concept study demonstrates that T2DM has significant rates of both NAFLD and advanced fibrosis. Concomitant screening for NAFLD and advanced fibrosis by using MRI-proton density fat fraction and magnetic resonance elastography in T2DM is feasible and may be considered after validation in a larger cohort.
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Aliment. Pharmacol. Ther. · Jan 2016
Combined ursodeoxycholic acid (UDCA) and fenofibrate in primary biliary cholangitis patients with incomplete UDCA response may improve outcomes.
Fibrates appear to improve biochemistry in patients with primary biliary cholangitis (PBC), but it is unclear which factors predict response and whether treatment improves transplant-free survival. ⋯ Fenofibrate therapy is associated with significant improvement in alkaline phosphatase, decompensation-free and transplant-free survival in PBC patients with incomplete UDCA response. However, fenofibrate should be used cautiously in cirrhosis, with close monitoring for clinical/biochemical decompensation. Additional studies are required to assess the validity of alkaline phosphatase as an appropriate response criteria for fibrate therapy.