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| 1 | Hepatitis E virus in patients with acute severe liver injury显示文摘AIM: To examine the incidence of hepatitis E(HepE) in individuals with acute liver injury severe enough to warrant treatment at a transplant unit.METHODS: Hepatitis E virus(HEV) is an emerging pathogen in developed countries causing severe illness, particularly in immunocompromised patients or those with underlying chronic liver disease. HepE infection isoften under diagnosed, as clinicians can be reluctant to test patients who have not travelled to regions traditionally considered hyperendemic for HepE. There are few data regarding the significance of HEV in patients with very severe acute liver injury in developed countries. Eighty patients with acute severe liver injury attending the Scottish Liver Transplant unit were tested for HEV and anti-HEV IgG and IgM. Severe acute liver injury was defined as a sudden deterioration in liver function confirmed by abnormal liver function tests and coagulopathy or presence of hepatic encephalopathy. Eighty percent of these patients were diagnosed with paracetomol overdose. No patients had a history of chronic or decompensated chronic liver disease at time of sampling. IgG positive samples were quantified against the World Health Organization anti-HEV IgG standard. Samples were screened for HEV viral RNA by quantitative reverse transcription polymerase chain reaction.RESULTS: Four cases of hepatitis E were identified. Three of the four cases were only diagnosed on retrospective testing and were initially erroneously ascribed to drug-induced liver injury and decompensated chronic liver disease, with the cause of the decompensation uncertain. One case was caused by HEV genotype 1 in a traveller returning from Asia, the other three were autochthonous and diagnosed on retrospective testing. In two of these cases(where RNA was detected) HEV was found to be genotype 3, the most prevalent genotype in developed countries. Three patients survived, two of whom had been misdiagnosed as having drug induced liver injury. The fourth patient died from sepsis and liver failure precipitated as a result of hepatitis E infection and previously undiagnosed cirrhosis. Histopathology data to date is limited to mainly that seen for endemic HepE. All patients, with the exception of patient 1, demonstrated characteristics of HepE infection, as seen in previously described locally acquired cases.CONCLUSION: In patients with acute severe liver injury, HEV testing should be part of the initial diagnostic investigation algorithm irrespective of suspected initial diagnosis, age or travel history. | Claire Louise Crossan Kenneth J Simpson Darren G Craig Christopher Bellamy Janice Davidson Harry R Dalton Linda Scobie | 2014 | World Journal of Hepatology2014，6，6： | 4 |
| 2 | Theatrical Improvisation: Lessons for Organizations显示文摘 | VERA D CROSSAN M | 2004 | Organization Studies2004，25，5： | 1 |
| 3 | An Organizational Learning Framework:From Intuition to Institution显示文摘 | CROSSAN M M LANE U W WHITE R E | 1999 | Academy of Management Review1999，24，3： | 1 |
| 4 | Improvisation and innovative performance in teams 显示文摘 | VERA Crossan | 2005 | Organization Science2005，16，3： | 1 |
| 5 | An organizational learning framework from intuition to institution 显示文摘 | Crossan M M Lane H W White R E | 1999 | Academy of Management Review1999，24，3： | 1 |
| 6 | Improvisation and Innova- tive Performance in Teams显示文摘 | VERA D CROSSAN M | 2005 | Organization Sci- ence2005，16，3： | 1 |
| 7 | A Multi - Dimensional Framework of Organizational Innovation : A Systematic Review of the Literature 显示文摘 | Crossan MM Apaydin M | 2010 | Journal of Management Studies2010，47，6： | 1 |
| 8 | A multi-dimensional frame- work of organizational innovation : a system review of the lit- erature显示文摘 | CROSSAN M M APAYDIN M | 2010 | Journal of Management Studies2010，47，6： | 1 |
| 9 | Reflections on the 2009AMR Decade Award:Do We have a Theory of Organizational Learning?显示文摘 | Crossan M M Maurer C C Whiter R E | 2011 | Academy of Management Review2011，36，3： | 1 |
| 10 | An Organizational Learning Framework:From Intuition to Institution显示文摘 | CROSSAN M LANE H W WHITE RE | | 0，，3： | 1 |
| 11 | Strategic Leadership and Organizational Learning显示文摘 | Vera D Crossan M | 2004 | Academy of Management Review2004，29，： | 1 |
| 12 | Strategic leadership for ex- ploration and exploitation: The moderating role of environmental dy- namism 显示文摘 | JANSEN J J P VERA D CROSSAN M | 2009 | The Leadership Quarterly2009，20，1： | 1 |
| 13 | An organizational learning framework:form intuition to institution显示文摘 | Lane H W White R E | 1999 | Academy of Management Review1999，3，： | 1 |
| 14 | Managing an organizational learning system by aligning stocks and flows of knowledge显示文摘 | Bontis N Crossan M Hulland J | 2001 | Journal of Management Studies2001，38，： | 1 |
| 15 | An organiza- tional learning framework: From intuition to institu- tion显示文摘 | Crossan M M Lane H W White R E | 1999 | Academy of management review1999，24，3： | 1 |
| 16 | Organizational Learning : Debates Past, Present and Future 显示文摘 | Easterly - Smith M Crossan M M Nicolini D | 2000 | Journal of Management Studies2000，37，6： | 1 |
| 17 | Improvisation and innovative performance in teams 显示文摘 | Vera D Crossan M | 2005 | Organization Science2005，16，3： | 1 |
| 18 | (1995) Organizational Learning: Dimensions for a Theory 显示文摘 | CROSSAN M M LANE H W WHITE R E | 1995 | The International Journal of Organizational Analysis1995，3，4： | 1 |
| 19 | Strategic leadership an organizational learning显示文摘 | Dusya Vera Mary Crossan | 2004 | Academy of Management Review2004，29，2： | 1 |
| 20 | An organizational learning framework:From intuition to institution显示文摘 | Crossan M M Lane H W White R E | | 0，，03： | 1 |
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