Chapters authored
Endoscopic Treatment of Gastrointestinal Bleedings By Paul Mitrut, Liliana Streba, Anca Oana Docea, Adina Kamal, Sorin
Ioan Zaharie , Costin Teodor Streba and Nicolae-Dragoș
Mărgăritescu
Digestive endoscopy represents an essential diagnostic and curative tool used when presented with a suspicion of gastrointestinal (GI) bleeding. Its role is not only confined to primary detection but also to establishing the severity of a lesion and providing relevant information regarding its risk of bleeding. New endoscopic techniques, accessories and compounds make the minimally invasive treatment suitable for a vast array of lesion types. Our main goal in this chapter is to summarize the main presentation of lesions at risk of bleeding, briefly classify them according to the gastrointestinal segment and finally detail the endoscopic treatment options currently available.
Part of the book: Endoscopy
Current Management Strategies in Hepatitis B During Pregnancy By Letiția Adela Maria Streba, Anca Pătrașcu, Aurelia Enescu and
Costin Teodor Streba
Hepatitis B virus (HBV) infection remains a major health problem worldwide and a major risk factor for end-stage liver disease and hepatocellular carcinoma. Notable differences of chronic hepatitis B prevalence were observed in geographic area. In highly endemic areas, at least 50 % of HBV infections are most commonly acquired either perinatally or in early childhood, during the first 5 years of life. The prevalence of chronic HBV infection in pregnant women is expected to mirror those in the general populations of each geographic area. Chronic hepatitis B during pregnancy is associated with high risk of maternal complications and an increased risk of mother-to-child transmission (MTCT). Thus, chronic hepatitis B during pregnancy can now be considered an important contributor to new HBV infections and to the global burden of disease. As a result, HBV infection during pregnancy requires management strategies for both the mother and the fetus/neonate, including prevention/elimination of MTCT and lessening the HBV effects on maternal and fetal health. This chapter will review current management strategies for hepatitis B in the pregnancy and the postpartum period, including special considerations on the effects of pregnancy on the course of HBV infection, MTCT, and antiviral therapy during the pregnancy.
Part of the book: Advances in Treatment of Hepatitis C and B
Oncological-Therapy-Associated Liver Injuries By Victor-Mihai Sacerdoțianu, Costin-Teodor Streba, Ion Rogoveanu, Liliana Streba and Cristin Constantin Vere
Drug-induced liver injury (DILI) represents a large group of hepatic disease caused by various treatments, including oncological agents. The liver is an important organ with a role in drug metabolization and excretion and may be affected when oncologic treatment is initiated. The most common liver disease patterns induced by oncologic therapy are steatosis and steatohepatitis, focal nodular hyperplasia, pseudocirrhosis, acute hepatitis, hepatic necrosis, immune-mediated hepatitis, cholestasis, fibrosis and cirrhosis, sinusal obstructive syndrome. In rare cases, chemotherapy treatment is associated with a high-risk hepatic adenoma or hepatocellular carcinoma development. It was demonstrated that the majority of chemotherapy classes can induce these effects on the liver, for example, alkylating agents, antimetabolites, and antitumor antibiotics, but also immunotherapy agents can be involved. The majority of patients that receive oncological treatment who developed liver injury as adverse reactions are identified by symptoms and/or blood test abnormalities. Imaging techniques may be helpful in the diagnosis of oncological-therapy-associated liver injuries, for example, focal nodular hyperplasia, pseudocirrhosis, and sinusal obstructive syndrome. If liver disease occurs as an adverse effect of these agents, the recommendation to stop or continue the administration of oncologic treatment with close monitoring relies upon the risk and benefits of this medication.
Part of the book: Hepatotoxicity
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