HA can be utilized as a reliable surrogate marker in distinguishing three clinically relevant stages of fibrosis: absent/minimal, intermediate, and advanced/cirrhosis. HA should be considered as a cost-effective alternative to other serum markers for staging fibrosis and for determining the timing and selection of HCV treatment.

Increased steatosis was associated with increased fibrosis. DQS was consistently more precise and reproducible than manual assessment of steatosis in grades 1 (1 to <6%) and 2 (6 to <34%), and may prove to be especially preferable in clinical trials of pharmacotherapeutic agents.

Secukinumab is an IgG monoclonal antibody widely used for treatment of ankylosing spondylitis, psoriasis, and psoriatic arthritis. Recently, there has been increasing controversy regarding potential adverse effects of the drug especially in those with underlying inflammatory bowel disease. We present the case of a young male patient who developed severe new-onset ulcerative colitis following initiation of secukinumab for psoriasis, with excellent response and rapid resolution of symptoms with infliximab.

Background: Controversy exists over whether or not single-needle liver biopsies are sufficient to compare histological parameters in patients with non-alcoholic fatty liver disease.Aims: To identify sampling variability, we biopsied four liver specimens per patient, based on biopsy size (needle vs wedge) and location (left vs right lobe), immediately prior to bariatric Roux-en-Y gastric bypass surgery.Methods: Ten prospectively enrolled, morbidly obese patients underwent 40 laparoscopy-guided biopsies; two needle and two wedge from each of 16 left and 16 right liver lobes. The Kappa coefficient for concordance compared histological parameters from left and right lobe needle- and wedge biopsies. Wedge biopsies were considered our ‘Gold Standard’.Results: Each patient had two wedge- and two needle liver biopsies. Kappa concordance between all needle and wedge biopsies from right and left lobes showed variability. Wedge- and needle liver biopsies from contralateral lobes had higher concordance with each other, compared to ipsilateral needle/wedge biopsy pairs. Contralateral wedge pairs had higher concordance than contralateral needle/needle pairs. There were no biopsy complications.Conclusions: Wedge biopsy pairs had the best Kappa concordance but contralateral needle/needle biopsy pairs had good Kappa concordance. There were no complications from the 40 needle- and wedge liver biopsies, confirming the safety of laporoscopic multi-biopsy in both liver lobes.

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