Hepatic encephalopathy (HE) is a reversible syndrome of impaired brain function and represents one of the many complications of portal hypertension and decompensated liver disease. Although ammonia is clearly implicated in the pathogenesis of HE, the pathogenesis of HE is multifactorial with numerous mechanisms that results in functional impairment of neuronal cells. The initial management of HE focuses on supportive care and stabilization which includes providing appropriate nutritional support. Thereafter, focus should be on identifying and treating the precipitating factors. There are many therapeutic agents available for the management of HE, most of which are directed towards lowering the gut nitrogen load and thus the serum ammonia level. This review aims to provide an update on the conventional and emerging treatment options for HE.
Women's support groups (WSGs) for resident physicians can bolster professional development, career advancement, networking opportunities, and collaboration across specialties. Additionally, WSGs can provide an outlet for women in residency to come together, share unique experiences, and alleviate burnout. Gender-specific groups have been shown to help women obtain leadership positions, find mentors, and advance in their careers, yet there is limited literature on successfully establishing a formal group. To address this gap, the authors created their own WSG, Women in Residency Life (WiRL). In doing so, they compiled 12 steps for creating a support group for women residents. Those steps serve as a foundational approach to establish a support group for women in residency to mitigate gender disparity.
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