If bile-duct stones are strongly suspected,
endoscopic retrograde cholangiopancreatography (ERCP) with transpapillary stone extraction is the method of choice. Endoscopic ultrasound and magnetic resonance cholangiopancreatography (MRCP) are less invasive diagnostic tools in patients with this website intermediate probability of intraductal stones. Treatment comprises medical therapy for acute pain and/or bacterial infection and endoscopic interventions for common bile-duct stones, cholangitis, or biliary pancreatitis in selected patients. Laparoscopic cholecystectomy is the treatment of choice for symptomatic gallbladder stones and cholecystitis. It should also be performed after other complications of cholelithiasis (e.g., biliary pancreatitis, cholangitis) to prevent recurrence. “
“This chapter contains sections titled: Introduction Background The role of the gastrointestinal tract in ingestive behavior Gastrointestinal symptoms and disease in the obese patient Bariatric surgery – a primer for the gastroenterologist Considerations in
endoscopy Endoscopic treatments for obesity References “
“Hepatitis B virus (HBV) causes important human health problems. It has infected one-third of the world’s population and approximately 360 million people are chronic carriers. Worldwide, 0.5–1.2 million deaths are attributed to HBV infection annually. Therefore, Selleck Metformin global control of HBV infection is important. HBV infection can be intervened by interrupting routes of transmission, treating the chronically infected, and preventing the susceptibles with immunoprophylaxis. All these measures are effective. Nevertheless, although pegylated interferons or nucleos(t)ide analogs are effective for the treatment of chronic hepatitis B, chronic carriage of HBV is not easy to eliminate, as revealed by the frequent persistence of hepatitis B surface antigen, despite satisfactory responses to these treatments. On the other hand, hepatitis B vaccination Dimethyl sulfoxide has been shown to preclude HBV infection effectively.
This is particularly true for pre-exposure prophylaxis. Worthy of note is the universal vaccination of newborn infants. This is the most effective means of preventing HBV infection, especially for those born to HBV carrier mothers. To eliminate and eradicate hepatitis B, first, HBV in the chronically infected should be eradicated or strongly and efficiently suppressed, so that the infection does not spread rampantly. Second, all the transmission routes should be interrupted. Lastly, but most effectively, is to immunize all susceptibles. The difficulties and possible solutions of each approach are discussed. In conclusion, the existing means to prevent and treat HBV infection render our goal toward eliminating and eradicating hepatitis B possible, although it will take much time and effort to achieve this objective. Hepatitis B virus (HBV) is one of the most important human pathogens. It causes significant diseases spanning from fulminant hepatitis to end-stage liver disease.