6 Noteworthily, the presence of fatty liver is completely ignored in the international consensus on MetS5 and in the guidelines on diabetes management from the American Diabetes Association.7 Strikingly, the decrease in IHTG with physical activity leads to a marked improvement in systemic insulin resistance independently of the decrease in visceral adipose tissue.8 Thus, we suggest that fatty liver management

should be a main goal in the treatment of MetS. Finally, we agree with the authors’ conclusions that prospective clinical studies will further clarify whether IHTG measurement can be a prompt predictor of the cardiometabolic risk. If this is the case, shall we call it fatty selleck compound liver syndrome? Federico Salamone M.D.*, Fabio Galvano Ph.D.†, Giovanni Li Volti M.D., Ph.D.†, * Department of Internal Medicine, University of Catania, Catania, Italy, † Department of

Biological Chemistry, Medical Chemistry, and Molecular Biology, University of Catania, Catania, Italy. “
“Magnetic resonance cholangiopancreatography (MRCP) is a useful non-invasive tool for the evaluation of biliary and pancreatic pathology. Its diagnostic ability has significantly improved since its introduction in 1991. As a consequence, endoscopic retrograde cholangiopancreatography Selleck HM781-36B is now reserved in many centers for intervention or when MRCP fails to establish the diagnosis. This chapter aims to familiarize the reader with the technique, and clinical indications and limitations of the investigation. Common pitfalls in interpretation are also addressed. “
“Background

and Aim:  Sorafenib, many the first agent demonstrated to have efficacy to improve the survival of patients with advanced hepatocellular carcinoma (HCC), is an active multikinase inhibitor affecting angiogenesis and tumor proliferation. We analyzed cytokines related to angiogenesis or cell proliferation, and tried to determine their utility as biomarkers of sorafenib treatment effect for HCC. Methods:  Nine serum cytokines (angiopoietin-2 [Ang-2], follistatin, granulocyte colony-stimulating factor [G-CSF], hepatocyte growth factor [HGF], interleukin-8 [IL-8], leptin, platelet-derived growth factor-BB, platelet endothelial cell adhesion molecule-1, and vascular endothelial growth factor) were measured in 30 HCC patients treated with sorafenib, and the effects of treatment were compared using modified Response Evaluation Criteria in Solid Tumors. Results:  All but IL-8 were significantly higher at baseline in patients with progressive disease. Progression-free survival was significantly shorter in patients with high levels of Ang-2, G-CSF, HGF, and leptin, and the hazard ratios were 2.51, 6.89, 2.55, and 4.14, respectively.