Citations 2
A multisociety consensus statement on a new common definition and diagnostic criteria for PSVD or NCPF
Hernández–Gea, Virginia , Paradis, Valerie , Guindi, Maha , Alves, Venancio A.F. , Aqul, Amal , Cerda, Eira , Murad, Sarwa Darwish , Das, Prasenjit , Giorgio, Angelo Di , Freitas, Luiz A.R. de , Grammatikopoulos, Tassos , Harada, Kenichi , Hernández, Nelia , Kakar, Sanjay , Karpen, Saul J. , Qi, X L, Sakhuja, Puja , Schinoni, Maria Isabel , Saxena, Romil , Shukla, Akash , Verna, Elizabeth C. , Wong, Kerry, Darwish Murad, Sarwa , Di Giorgio, Angelo , de Freitas, Luiz A R , Ibrahim, Samar H , Kakar, Sanjay , Karpen, Saul , Kleiner, David Erwin , Ormeci, Necati , Qi, Xiaolong , Sakhuja, Puja , Schinoni, Maria Isabel , Saxena, Romil , Sayadi, Alexandre , Shukla, Akash , Tiniakos, Dina , Verna, Elizabeth C , Elkrief, Laure , Sempoux, Christine , Heller, Theo , Rautou, Pierre-Emmanuel , Aqul, Amal , Das, Prasenjit , Hernández–Gea, Virginia , Paradis, Valérie , Guindi, Maha M. , Cerda, Eira, Grammatikopoulos, Tassos , Harada, Kenichi , Hernández, Nelia , Ibrahim, Samar H. , Sayadi, Alexandre , Heller, Theo
Hepatology | May 27, 2026 | Volume: 84 | Issue: 2 | Pages: 601-616
Noncirrhotic portal hypertension has historically been described using heterogeneous and region-specific terminology—such as idiopathic portal hypertension (IPH), noncirrhotic portal fibrosis (NCPF), obliterative portal venopathy, and nodular regenerative hyperplasia—leading to substantial variability in diagnosis, reporting, and international research collaboration. Differences in guideline definitions from major societies (AASLD, EASL, and APASL), together with the presence of characteristic histologic lesions in patients without clinically overt portal hypertension, have further complicated disease classification. To address these challenges, a large, multisociety, international initiative was convened to harmonize nomenclature and diagnostic criteria. Representatives from liver, pathology, and pediatric hepatology societies across the Americas, Europe, and Asia participated in a structured consensus process that included specialized working groups and external Delphi validation. The initiative produced a globally harmonized and implementable diagnostic framework. Consensus was reached that the terms porto-sinusoidal vascular disorder (PSVD) and NCPF may be used interchangeably when identical diagnostic criteria are applied, and that they should be written as PSVD or NCPF . The diagnosis was defined as fundamentally clinicopathological, requiring integrated assessment. Core principles include the need for a high-quality liver biopsy (≥10 mm), mandatory exclusion of cirrhosis, and systematic exclusion of specific alternative conditions. Importantly, the consensus recognizes that PSVD or NCPF may be diagnosed even without clinical portal hypertension and may coexist with other liver diseases, provided cirrhosis is excluded. Standardized major and minor histologic criteria were developed collaboratively by expert pathologists and externally validated. Features of portal hypertension were harmonized into specific and nonspecific categories applicable to routine clinical practice. An integrated diagnostic scoring system incorporating histology, clinical features, associated conditions, and concommitant etiologies was developed and validated using the Delphi method. This consensus provides the first internationally endorsed, unified framework for the diagnosis of PSVD or NCPF. Its global implementation is expected to reduce diagnostic variability, improve comparability across regions, and facilitate the development of robust, internationally harmonized clinical and translational research cohorts.
Impact of exposure to patients with COVID-19 on residents and fellows: an international survey of 1420 trainees
Cravero, Anne , Kim, Nicole J. , Feld, Lauren D. , Rabiee, Atoosa , Bazarbashi, Najdat , Bassin, Sandhya R. , Lee, Tzu-Hao, Moon, Andrew M. , Liang, Peter S. , Aby, Elizabeth S. , Khan, Mohammad Qasim , Young, Kristen , Kobeissy, Abdallah, Hashim, Almoutaz, Houser, Allysia, Ioannou, George N. , Cravero, Anne L , Young, Kristen J , Liang, Peter S , Moon, Andrew M , Berry, Kristin , Qi, Xiaolong , Patel, Arpan , Wijarnpreecha, Karn , Khan, Mohammad Qasim
Postgraduate Medical Journal | October 21, 2020 | Volume: 97 | Issue: 1153 | Pages: 706-715
10.1136/postgradmedj-2020-138789
ABSTRACTObjectivesTo determine how self-reported level of exposure to patients with novel coronavirus 2019 (COVID-19) affected the perceived safety, training and well-being of residents and fellows.MethodsWe administered an anonymous, voluntary, web-based survey to a convenience sample of trainees worldwide. The survey was distributed by email and social media posts from April 20th to May 11th, 2020. Respondents were asked to estimate the number of patients with COVID-19 they cared for in March and April 2020 (0, 1–30, 31–60, >60). Survey questions addressed (1) safety and access to personal protective equipment (PPE), (2) training and professional development and (3) well-being and burnout.ResultsSurveys were completed by 1420 trainees (73% residents, 27% fellows), most commonly from the USA (n=670), China (n=150), Saudi Arabia (n=76) and Taiwan (n=75). Trainees who cared for a greater number of patients with COVID-19 were more likely to report limited access to PPE and COVID-19 testing and more likely to test positive for COVID-19. Compared with trainees who did not take care of patients with COVID-19 , those who took care of 1–30 patients (adjusted OR [AOR] 1.80, 95% CI 1.29 to 2.51), 31–60 patients (AOR 3.30, 95% CI 1.86 to 5.88) and >60 patients (AOR 4.03, 95% CI 2.12 to 7.63) were increasingly more likely to report burnout. Trainees were very concerned about the negative effects on training opportunities and professional development irrespective of the number of patients with COVID-19 they cared for.ConclusionExposure to patients with COVID-19 is significantly associated with higher burnout rates in physician trainees.