Current Management Strategies in Hepatitis B During Pregnancy

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

Endoscopic Treatment of Gastrointestinal Bleedings

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

Mobile Application for Inflammatory Bowel Disease Monitoring: A Romanian Perspective

Inflammatory Bowel Disease (IBD) encompasses a cluster of chronic inflammatory disorders affecting the gastrointestinal tract. The primary objective of IBD treatment is the management of inflammation, symptom control, and the induction and sustenance of remission. Therapeutic interventions commonly encompass medications, dietary modifications, and, in certain instances, surgical procedures; however, a definitive cure remains elusive. While several nations have established national IBD registries, Romania has not. The responsibility of the implementation of such a registry was assumed by a non-profit organization, the "Clubul Român de Boală Crohn și Colită Ulcerativă", resulting in the creation of the registrul-ibd.ro platform. Given the absence of a curative remedy for IBD, it falls within the realm of personalized medicine. In light of this, the University of Medicine and Pharmacy of Craiova has developed a mobile application, IBDMonitor, intricately linked with the IBD registry. This innovative application empowers patients to meticulously record critical data, encompassing medication administration, symptomatology, lifestyle habits, as well as physiological, pathological, and daily occurrences. Medical professionals are granted real-time access to these patient-generated reports, enabling them to make prompt treatment adjustments. Following a successful pilot phase, various insights have emerged, notably revealing a relatively low long-term adherence rate to the application. Consequently, advocating for the widespread adoption of both the application and the registry on a national scale holds the potential to significantly enhance the utilization of these invaluable tools in the management of IBD