On the basis of a retrospective analysis of 124 patients, endoscopic therapy of WON by using LAMS is safe and effective. Creation of a large and sustained cystogastrostomy or cystoenterostomy tract is effective in the drainage and treatment of WON.

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FIGURE. Prevalence of provider recommendation for and offer of influenza vaccination* and influenza vaccination coverage † among women pregnant any time during October-January-Internet panel survey, United States, 2010-11 through 2016-17 influenza seasons

Background Non-alcoholic fatty liver disease (NAFLD) is common in patients with inflammatory bowel disease (IBD). This study evaluated the prevalence of NAFLD and the associated risk factors among IBD patients who received anti-tumor necrosis factor (TNF) therapy. Methods Adult IBD patients receiving anti-TNF therapy (infliximab, adalimumab, certolizumab, golimumab) were enrolled. Hepatic steatosis was assessed by abdominal ultrasound. Patients with a history of excessive alcohol or recent steroid use were excluded. Univariate and multivariate analysis were performed. Results Eighty patients, 55% male, mean age 42±15 years, were enrolled. The sonographic prevalence of NAFLD was 54% (43/80), significantly higher than the general prevalence in the US adult population (30%) (P<0.0001). NAFLD patients had a significantly higher proportion of males, as well as greater body weight and body mass index, compared to non-NAFLD. The Crohns disease activity index (CDAI) was significantly higher among patients with NAFLD. Multivariate analysis demonstrated that a higher CDAI was independently associated with NAFLD, with an odds ratio of 1.6 (95% confidence interval 1.05-2.44; P=0.03). Conclusions The presence of IBD is strongly associated with NAFLD. We identified a high prevalence of NAFLD among IBD patients receiving anti-TNF. CDAI was independently associated with hepatic steatosis. Further studies are still needed to evaluate the pathophysiology of NAFLD development and disease progression among IBD populations.

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Marijuana (MJ) is the most commonly used illicit drug in the UnitedStates with an estimated 10% of US adults reporting active MJ use in the past month. 1 The prevalence of MJ use in the US has significantly increased over the past 15 years. 1 Touted clinical uses of MJ include the treatment of pain, muscle spasticity, refractory epilepsy, and nausea. 2 However, MJ use has also been associated with various adverse effects including infection, cardiopulmonary disease, neuropsychiatric, and behavioral problems. 3 More than 50% of LT candidates have substance use disorder (SUD) including alcohol-related liver disease (ALD) and injection drug use associated with viral hepatitis. 4 MJ use among solid organ transplant patients is an area of little policy uniformity. Many studies have demonstrated adverse effects of tobacco use in LT candidates and recipients resulting in many US programs prohibiting tobacco use in their LT candidates. [5][6][7] Only a few studies have investigated the potential harm of MJ use in LT candidates and recipients and risks remain largely unknown. As such, national MJ-related policies and procedures for the evaluation and listing of transplant patients remain highly variable. 8,9

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Background Non-alcoholic fatty liver disease (NAFLD) is common in patients with inflammatory bowel disease (IBD). The purpose of this study was to further examine the prevalence of NAFLD in IBD patients. Methods We retrospectively reviewed the medical records of IBD patients who visited the emergency department because of abdominal pain between January 2009 and December 2014. These were compared with a group of 70 controls without IBD, matched for age and body mass index (BMI). Computed tomography data were analyzed for the presence or absence of hepatic steatosis. Patient with recent steroid or excessive alcohol use were excluded. Univariate and multivariate analyses were performed. Results NAFLD prevalence was 44% (31/70) in the IBD group vs. 16% (11/70) in controls (P<0.001). There was no significant difference between the 2 groups in age, sex distribution, BMI, presence of diabetes, or levels of serum transaminases, serum albumin or platelets. In multivariate analysis, the presence of IBD was independently associated with NAFLD (odds ratio 4.53, 95% confidence interval 2.00-10.26; P=0.002). Conclusions The presence of IBD is strongly and independently associated with NAFLD. Systemic inflammation and alteration of the intestinal microbiome have been proposed as mechanisms, but further studies are needed to better elucidate the pathophysiology.