Randomized intervention and outpatient follow-up lowers 30-d readmissions for patients with hepatic encephalopathy, decompensated cirrhosis.

Background: We previously reported national 30-d readmission rates of 27% in patients with decompensated cirrhosis (DC).

Aim: To study prospective interventions to reduce early readmissions in DC at our tertiary center.

Methods: Adults with DC admitted July 2019 to December 2020 were enrolled and randomized into the intervention (INT) or standard of care (SOC) arms.

Impact of Cannabis Use on Inpatient Inflammatory Bowel Disease Outcomes in 2 States Legalizing Recreational Cannabis.

Background: We evaluated the impact of recreational cannabis legalization on use and inpatient outcomes of patients with inflammatory bowel disease (IBD).

Methods: Hospitalized adult patients in Colorado and Washington before (2011) and after (2015) recreational cannabis legalization were compared by chi-square tests for categorical variables and -tests for continuous variables. Multivariable regression models adjusting for demographic data were fit to assess the association of cannabis use with hospital outcomes.

Epidemiologic and socioeconomic factors impacting hepatitis B virus and related hepatocellular carcinoma.

Chronic Hepatitis B is a highly prevalent disease worldwide and is estimated to cause more than 800000 annual deaths from complications such as cirrhosis and hepatocellular carcinoma (HCC). Although universal hepatitis B vaccination programs may have reduced the incidence and prevalence of chronic hepatitis B and related HCC, the disease still imposes a significant healthcare burden in many endemic regions such as Africa and the Asia-Pacific region. This is especially concerning given the global underdiagnosis of hepatitis B and the limited availability of vaccination, screening, and treatment in low-resource regions.

Impact of rapid infliximab infusions on access at a large academic tertiary medical center.

Purpose: Infliximab promotes remission in patients with inflammatory bowel disease (IBD) and rheumatologic disease (RD). Rapid infliximab infusions (RI) reduce infusion time from 2 hours to 1 hour and can enhance access to care, as defined by capacity, safety, and patient characteristics. Our hypothesis for the study described here was that use of RI can enhance access for patients.

Spirulina breath test indicates differences in gastric emptying based on age, gender, and BMI.

Background: Measurements of gastric emptying (GE) by scintigraphy in the pediatric population are based on adult standards. Due to radiation exposure, scintigraphy cannot be performed on healthy children to establish norms of GE in the pediatric population. Stable isotope breath tests (GEBTs) pose no such health risk to children.

Migration of Gastric Varix Coil After Balloon-Occluded Antegrade Transvenous Obliteration.

This is a case report of a man with alcoholic cirrhosis who underwent transjugular intrahepatic portosystemic shunt and balloon-occluded antegrade transvenous obliteration for gastric fundal varices in 2017. After almost a year, we found extensive migration of the coil into the gastric fundus on upper endoscopy. Continued vigilant surveillance endoscopy may help detect this complication.

Pancreatic Cystic Lesions: Pathogenesis and Malignant Potential.

Pancreatic cancer remains one of the most lethal cancers despite extensive research. Further understanding of precursor lesions may enhance the ability to treat and prevent pancreatic cancer. Pancreatic cystic lesions (PCLs) with malignant potential include: mucinous PCLs (intraductal papillary mucinous neoplasms and mucinous cystic neoplasm), solid pseudopapillary tumors and cystic neuroendocrine tumors.

Commentary: Flawed scientific-evidence standards delay diesel regulations.

Of 188 government-monitored air toxics, diesel particulate matter (DPM) causes seven times more cancer than all the other 187 air toxics combined, including benzene, lead, and mercury. Yet, DPM is the only air toxic not regulated more stringently under the Clean Air Act, as a hazardous air pollutant (HAP). One reason is that regulators use flawed standards of scientific evidence.

Incidence, pattern, and etiology of elevated liver enzymes in pediatric inflammatory bowel disease.

Objectives: Patients with inflammatory bowel disease (IBD) often develop elevated liver enzymes (ELE), which are frequently a benign, transient finding, but may be related to treatment or IBD-associated liver diseases. Distinguishing benign from pathologic ELE is crucial for focused diagnostic and therapeutic interventions. We sought to characterize the incidence, character, chronicity, degree, and etiology of ELE in children with IBD.