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Viral etiologies of acute liver failure

World Journal of Virology 2024年第3期13卷 26-40页

作者： Brian W McSteen Xiao-Han Ying catherine lucero Arun B Jesudian Department of Medicine New York-Presbyterian/Weill Cornell CampusNew YorkNY 10021United States Department of Gastroenterology and Hepatology Weill Cornell MedicineNew YorkNY 10021United States

Acute liver failure(ALF)is a rare cause of liver-related mortality worldwide,with an estimated annual global incidence of more than one million *** drug-induced liver injury,including acetaminophen toxicity,is the leading cause of ALF in the Western world,viral infections remain a significant cause of ALF and the most common cause in many developing *** the high mortality rates associated with ALF,healthcare providers should be aware of the broad range of viral infections that have been implicated to enable early diagnosis,rapid treatment initiation when possible,and optimal management,which may include liver *** review aims to provide a summary of viral causes of ALF,diagnostic approaches,treatment options,and expected outcomes.

关键词： Acute liver failure Viral hepatitis Hepatitis B Hepatitis C Hepatitis A Liver disease Hepatology

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Disruptive behavior in the workplace: Challenges for gastroenterology fellows

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World Journal of Gastroenterology 2017年第18期23卷 3315-3321页

作者： Nalinee Srisarajivakul catherine lucero Xiao-Jing Wang Michael Poles Colleen Gillespie Sondra Zabar Elizabeth Weinshel Lisa Malter Division of Gastroenterology VA New York Harbor Healthcare System Division of General Internal Medicine NYU School of Medicine Division of Gastroenterology and Hepatology Weill Cornell Medical College Department of Internal Medicine Emory University School of Medicine

To assess first-year gastroenterology fellows’ ability to address difficult interpersonal situations in the workplace using objective structured clinical examinations (OSCE).METHODSTwo OSCEs (“distracted care team” and “frazzled intern”) were created to assess response to disruptive behavior. In case 1, a fellow used a colonoscopy simulator while interacting with a standardized patient (SP), nurse, and attending physician all played by actors. The nurse and attending were instructed to display specific disruptive behavior and disregard the fellow unless requested to stop the disruptive behavior and focus on the patient and procedure. In case 2, the fellow was to calm an intern managing a patient with massive gastrointestinal bleeding. The objective in both scenarios was to assess the fellows’ ability to perform their duties while managing the disruptive behavior displayed by the actor. The SPs used checklists to rate fellows’ performances. The fellows completed a self-assessment *** fellows from four gastrointestinal fellowship training programs participated in the OSCE. In the “distracted care team” case, one-third of the fellows interrupted the conflict and refocused attention to the patient. Half of the fellows were able to display professionalism despite the heated discussion nearby. Fellows scored lowest in the interprofessionalism portion of post-OSCE surveys, measuring their ability to handle the conflict. In the “frazzled intern” case, 68% of fellows were able to establish a calm and professional relationship with the SP. Despite this success, only half of the fellows were successfully communicate a plan to the SP and only a third scored “well done” in a domain that focused on allowing the intern to think through the case with the fellow’s *** must receive training on how to approach disruptive behavior. OSCEs are a tool that can assess fellow skills and set a culture for open discussion.

关键词： Disruptive behavior Fellowship education and training Objective structured clinical examinations

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