The early-onset type, as in this case, occurs within 2 weeks of surgery and typically presents with small intestinal obstruction. Richter’s hernia, when the anti-mesenteric wall of the intestine protrudes through the hernia defect, occurs in approximately half of find more early-onset cases. CT scan of the abdomen effectively diagnoses early-onset-type hernia and can precisely locate the site of incarceration. Trocar site hernia is primarily related to a large trocar size (> 10 mm) that leaves the fascial defect open, and

stretching of the portal site. Most surgeons now routinely close the fascial defect and peritoneum to prevent herniation. The majority of trocar site hernia-related small-bowel obstruction is not improved by conservative management and requires surgical management. Non-operative treatment sometimes leads to complications. Open or laparoscopic repair of the hernia with reduction of the incarcerated

bowel and repair of the fascial defect can recommended. Contributed by “
“We read with great PARP inhibitor interest the article by Harrison et al.1 regarding the predictive role of serum lipids in the standard treatment of chronic viral hepatitis C with pegylated interferon and ribavirin. We think that the clinical implications extracted from this study deserve further examination. First, alcohol use in patients with chronic hepatitis C has been associated with decreased rates of sustained virological response in some studies even though the exact amount of alcohol consumption and the exact nature of the habit (current or past alcohol use) have remained unknown.2-4 In Harrison et al.1′s article,1 we did not notice any information about

the alcohol consumption of the study participants. Second, according to their study,1 low high-density lipoprotein Afatinib manufacturer (HDL) levels and elevated low-density lipoprotein (LDL) levels are positive prognostic factors for a treatment response in patients with chronic hepatitis C. However, to the best of our knowledge, smoking and exercise are the main determinants of the HDL level. Although the smoking status of the study participants was shown in the baseline demographic data, the exercise status of the patients was not provided, and this may have strikingly affected the results. Some studies have suggested that interleukin-28B has a role in the treatment response differences among patients with chronic hepatitis C undergoing interferon therapy. Various ethnic groups express this gene in different ways. This is also a predictive factor for the treatment response and may explain why some groups of the same ethnic background respond to treatment better in comparison with other ethnic groups; however, additional studies are needed to confirm its importance.