Hepatic encephalopathy (HE) is a severe neuropsychiatric syndrome that most commonly occurs in decompensated liver cirrhosis and incorporates a spectrum of manifestations that ranges from mild cognitive impairment to coma. Although the etiology of HE is not completely understood, it is believed that multiple underlying mechanisms are involved in the pathogenesis of HE, and one of the main factors is thought to be ammonia; however, the ammonia hypothesis in the pathogenesis of HE is incomplete. Recently, it has been increasingly demonstrated that inflammation, including systemic inflammation, neuroinflammation and endotoxemia, acts in concert with ammonia in the pathogenesis of HE in cirrhotic patients. Meanwhile, a good number of studies have found that current therapies for HE, such as lactulose, rifaximin, probiotics and the molecular adsorbent recirculating system, could inhibit different types of inflammation, thereby improving the neuropsychiatric manifestations and preventing the progression of HE in cirrhotic patients. The anti-inflammatory effects of these current therapies provide a novel therapeutic approach for cirrhotic patients with HE. The purpose of this review is to describe the inflammatory mechanisms behind the etiology of HE in cirrhosis and discuss the current therapies that target the inflammatory pathogenesis of HE.

• Inflammation
• Hepatic encephalopathy
• Pathogenesis
• Treatment

• Animals
• Anti-Inflammatory Agents/therapeutic use
• Hepatic Encephalopathy/diagnosis
• Hepatic Encephalopathy/drug therapy
• Hepatic Encephalopathy/etiology
• Hepatic Encephalopathy/metabolism
• Humans
• Inflammation Mediators/antagonists & inhibitors
• Inflammation Mediators/metabolism
• Liver Cirrhosis/complications
• Liver Cirrhosis/diagnosis
• Signal Transduction/drug effects
• Treatment Outcome

Many epidemiological and experimental studies have suggested that dietary fiber plays an important role in colon cancer prevention. These findings may relate to the ability of fiber to reduce the contact time of carcinogens within the intestinal lumen and to promote healthy gut microbiota, which modifies the host’s metabolism in various ways. Elucidation of the mechanisms by which dietary fiber-dependent changes in gut microbiota enhance bile acid deconjugation, produce short chain fatty acids, and modulate inflammatory bioactive substances can lead to a better understanding of the beneficial role of dietary fiber. This article reviews the current knowledge concerning the mechanisms via which dietary fiber protects against colon cancer.

• Dietary fiber
• Gut microbiota
• Colon cancer

• Appendiceal mucinous cystadenoma
• Background population
• Cancer risk
• Extra-intestinal cancer
• Inflammatory bowel disease
• Neuroendocrine carcinoma
• Rectal carcinoid
• Urothelial carcinoma

• Adult
• Case-Control Studies
• Digestive System Neoplasms/epidemiology
• Female
• Follow-Up Studies
• Hospitals, University
• Humans
• Incidence
• Inflammatory Bowel Diseases/epidemiology
• Male
• Middle Aged
• Odds Ratio
• Prospective Studies
• Registries
• Risk Assessment
• Risk Factors
• Spain/epidemiology
• Time Factors
• Urinary Bladder Neoplasms/epidemiology

Hepatocellular carcinoma (HCC) represents one of the most common neoplasms worldwide. Surgical resection and local ablative therapies represent the most frequent first lines therapies adopted when liver transplantation can not be offered or is not immediately accessible. Hepatic resection (HR) is currently considered the most curative strategy, but in the last decade local ablative therapies have started to obtain satisfactory results in term of efficacy and, of them, radiofrequency ablation (RFA) is considered the reference standard. An extensive literature review, from the year 2000, was performed, focusing on results coming from studies that directly compared HR and RFA. Qualities of the studies, characteristics of patients included, and patient survival and recurrence rates were analyzed. Except for three randomized controlled trials (RCT), most studies are affected by uncertain methodological approaches since surgical and ablated patients represent different populations as regards clinical and tumor features that are known to affect prognosis. Unfortunately, even the available RCTs report conflicting results. Until further evidences become available, it seems reasonable to offer RFA to very small HCC (< 2 cm) with no technical contraindications, since in this instance complete necrosis is most likely to be achieved. In larger nodules, namely > 2 cm and especially if > 3 cm, and/or in tumor locations in which ablation is not expected to be effective or safe, surgical removal is to be preferred.

• Hepatocellular carcinoma
• Hepatic resection
• Surgical therapy
• Ablation techniques
• Survival
• Liver failure

• Carcinoma, Hepatocellular/mortality
• Carcinoma, Hepatocellular/secondary
• Carcinoma, Hepatocellular/surgery
• Catheter Ablation/adverse effects
• Catheter Ablation/mortality
• Hepatectomy/adverse effects
• Hepatectomy/mortality
• Humans
• Liver Neoplasms/mortality
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Neoplasm Recurrence, Local
• Patient Selection
• Practice Guidelines as Topic
• Risk Factors
• Treatment Outcome
• Tumor Burden

As is the case in all areas of gastroenterology and hepatology, in 2009 and 2010 there were many advances in our knowledge and understanding of small intestinal diseases. Over 1000 publications were reviewed, and the important advances in basic science as well as clinical applications were considered. In Part II we review six topics: absorption, short bowel syndrome, smooth muscle function and intestinal motility, tumors, diagnostic imaging, and cystic fibrosis.

• Absorption
• Cystic fibrosis
• Diagnostic imaging
• Intestinal motility
• Short bowel syndrome
• Smooth muscle function
• Tumors