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At least 397 records · Page 22Linked to original sources

PubMed2004

[Intraoperative treatment of cyst contents in abdominal echinococcosis].

OBJECTIVE: To study the methods for intraoperative treatment of the cyst contents in patients with abdominal echinococcosis. METHOD: Sixty-nine cases of abdominal echinococcosis were reviewed for intraoperative disposal of the cyst contents using 5% formaldehyde (group A, 33 cases) or 25% NaCl solution (group B, 36 cases), and the effects and incidence of complications were compared. RESULTS: No relapse occurred in 33 cases with 5% formaldehyde treatment of the cyst contents, but postoperative intestinal fistula took place in 8 cases. In 36 cases with 25% NaCl treatment of the cyst contents, relapse occurred in one case postoperatively but no complications were seen in other patients. CONCLUSION: Treatment of the cyst contents with 5% formaldehyde may lead to intestinal fistula, and 25% NaCl solution may give rise to the risk of recurrence, so that both methods need improvement.

Abdomen↗

PubMed2004

[Gene cloning, expression and serological evaluation of diagnostic antigen Em18 for alveolar echinococcosis].

OBJECTIVE: To clone, express and serologically evaluate the Em18 antigen gene of Echinococcus multilocularis for diagnostic purpose. METHODS: Polymerase chain reaction (PCR) was employed for amplification of the target gene fragments which was then ligated with pET28a+ vector. The constructed plasmid was transferred into E. coli BL21 (DE3) for expression. The recombinant proteins were purified with Ni-NTA agarose by affinity chromatography. 237 sera were used for evaluating diagnostic value of the recombinant Em18 antigen. RESULTS: Two high-level expression clones (designated as ReEm18-1 and ReEm18-2) were obtained. ReEm18-1 showed the expected sequence, ReEm18-2 showed the same sequence but with 27 nucleotides deletion. The molecular weight of the two expression proteins was Mr 28,000 and 26,000, respectively. Serological evaluation by ELISA was carried out using sera from 101 patients with alveolar echinococcosis (AE), 47 with cystic echinococcosis (CE), 30 with cysticercosis (CC), 10 with hepatic cancer (HC), 9 with schistosomiasis (Sj) and 40 from healthy persons (NH) from both endemic and non-endemic areas. The results showed an overall sensitivity of 86.1% and 90.1% with ReEm18-1 and ReEm18-2 for AE sera, specificity 93.4% and 94.1%, positive predictive value 90.6% and 91.9%, negative predictive value 90.1% and 92.8% and efficiency 90.3% and 92.4%, respectively. The correlation analysis between the size of AE lesions and the serum absorbance reacted with recombinant Em18 antigens showed that there was a positive correlation between antibody level and the course of the disease. CONCLUSION: ReEm18 antigens are specific for AE diagnosis, and the serum antibody level displays a good correlation with the course of the disease at early stage. Similar results achieved by both ReEm18-1 and ReEm18-2 antigens.

Animals↗

PubMed2005

Hepatic alveolar echinococcosis: clinical and radiologic features and endoscopic management.

Hepatic alveolar echinococcosis is a rare but potentially life-threatening serious parasitic disease, developing as a result of intrahepatic growth of Echinococcus multilocularis larvae. It may present as an invasive mass causing biliary obstruction or portal hypertension due to invasion of the biliary and vascular structure of the liver. The only curative treatment of the disease is surgical resection; however, early diagnosis is the key point to achieve complete cure. In advanced disease, complications are common. We retrospectively analyzed 12 cases of hepatic alveolar echinococcosis and reviewed the relevant literature. A high index of suspicion and specific radiologic findings are very helpful in the diagnosis of the disease. While benzimidazole derivatives are used for the control of disease, endoscopic retrograde cholangiopancreatography is particularly effective in the biliary involvement, even in the late stage of disease.

Adult↗

PubMed2005

Economic effects of echinococcosis in a disease-endemic region of the Tibetan Plateau.

This report attempts to quantify the economic losses due to Echinococcus multilocularis and E. granulosus in Shiqu County, Sichuan, People's Republic of China, as well as illustrate the cost effectiveness of dog anthelmintic prophylaxis combined with a sheep and goat vaccination program in terms of disability-adjusted life years (DALYs) saved. We evaluated human losses associated with treatment costs and loss of income due to morbidity and mortality, in addition to production losses in livestock due to E. granulosus infection. Annual combined human and animal losses (95% confidence interval) is estimated to reach 218,676 U.S. dollars (189,850-247,871 U.S. dollars) if only liver-related losses in sheep, goats, and yaks are taken into account. This equates to approximately 3.47 U.S. dollars per person annually or 1.4% of per capita gross domestic product. However, total annual losses can be nearly 1,000,000 U.S. dollars if additional livestock production losses are assumed. Eventual prevention of 65-95% of annual losses due to cystic echinococcosis is suggested with proposed biannual dog anthelmintic prophylaxis and a sheep and goat vaccination program. Prevention of 9-50% of human alveolar echinococcosis-associated losses is suggested based on stochastic models for the current epidemiologic situation. The median estimated cost of the program would be approximately 56,000 U.S. dollars per year, which is a fraction of the estimated combined livestock and human financial losses due to the disease. Overall cost for the proposed control program is within the World Health Organization second most cost-effective band of less than 150 U.S. dollars per DALY averted. However, cost per DALY averted would be less than 25 U.S. dollars dollars for the human health sector if cost sharing was implemented between the public health and agricultural sectors based on proportional benefit from control.

Animals↗

PubMed2004

Cystic echinococcosis in Sardinia: the current role of sheep.

Cystic echinococcosis is one of the most widespread parasitosis in the Mediterranean region. Unfortunately this is also true for Sardinia for various reasons, among which is the close relationship between sheep and dogs in the farms. This work first epidemiologically analyses hydatidosis in sheep in Sardinia and then examines the most important causes of the persistence of these metacestodosis in sheep. The work looks at the factors which are responsible for the enormous quantity of illegal slaughtering and the widespread habit of abandoning the sheep carcasses in the grazing areas, as well as possible initiatives which may eliminate these practices. Such initiatives must include reducing the financial costs and bureaucracy involved when sheep are slaughtered in abattoirs, and also increasing the value of sheep meat. In conclusion new checks and controls are hoped for at a political level which will increase the financial support for the farmers and encourage the use of recombinant vaccines which have already been tested in Sardinia. These are extremely useful for effectively curbing cystic echinococcosis.

Abattoirs↗

PubMed2005

[Treatment of hydatid echinococcosis of liver].

Experience of surgical treatment of 373 patients with echinococcosis of liver is analyzed. Traditional surgeries were performed in 342 patients. Postoperative lethality was 1.46%, number of specific postoperative complications -- 12.5%. In long-term period recurrence was revealed in 18 (6.8%) of 264 examined patients. In 9 years after surgery residual cavities were diagnosed in 33 (9.64%) patients. Recovery was achieved in 93% patients. Experience of treatment of 31 patients with echinococcosis of liver with puncture methods (PAIR, PEVAC) was also analyzed. There were no lethal outcomes, severe complications and recurrences of disease during 2 years of follow-up. It is concluded that puncture method may be regarded as alternative for traditional surgical treatment, but it require further study.

Adolescent↗

PubMed2006

[Echinococcosis of the heart].

Basic clinical and special methods of diagnosis of cardiac echinococcosis are described. Among 12 patients with cardiac echinococcosis 5 patients have been operated and 7 patients have been not. Five of seven non-operated patients died during 1 year due to disruption of the cysts. All 5 operated patients survived. It is demonstrated that surgical treatment should be performed with artificial extracorporeal circulation, and postoperative anti-recurrent anti-helminth therapy is mandatory. Medication before surgical procedures is contraindicated because it leads to cysts disruption with high risk of lethal outcome.

Adolescent↗

PubMed2006

Cystic echinococcosis in Central Anatolia, Turkey.

OBJECTIVE: Human cystic echinococcosis (CE) caused by infection with a larval stage of Echinococcus granulosus is a serious public health problem in Turkey. Echinococcosis is a zoonotic disease; dogs and livestock are important hosts in transmission. The aim of this study is to evaluate the rate of CE in Kayseri Rural Area, Central Anatolia, Turkey. METHODS: At the present study, we planned to evaluate the rate of CE in Kayseri rural area in Central Anatolia between 2000 and 2002. We investigated 2,242 subjects using enzyme-linked immunosorbent assay (ELISA) and indirect fluorescence antibody (IFA), and we examined the seropositivity by using Western blotting (WB). RESULTS: The seropositivity rate was 2.7% by ELISA and IFA. We retested seropositive serum samples and 200 seronegative sera by WB. Seropositive serum samples were studied using abdominal ultrasound and chest x-ray to confirmed the presence of hydatid cyst and we found 10 (0.5%) different localized cysts. CONCLUSION: The results of our study indicate that Kayseri rural area has a high endemicity of human CE.

Adolescent↗

PubMedDate not supplied

Cardiac echinococcosis with intra-atrial localization.

Echinococcosis is a frequently encountered parasitic disease in the Mediterranean region, including Turkey. Cardiac disease is seen in 0.5-2% of patients. Usually the cysts are located within the pericardium or intramyocardially; intracavitary localization of the cyst is rarely seen. We herein report a patient who initially presented with hemoptysis and was echocardiographically diagnosed to have an intra-atrial hydatid cyst. Although patients with cardiac hydatid cysts may present with cardiac symptoms, symptoms typically involve other organ systems, following dissemination of the organism. Therefore, echocardiographic screening of patients who are diagnosed with echinococcosis, even if they have no cardiac symptoms, may ensure early diagnosis and prevent development of lethal complications, such as cyst rupture or embolization.

Echinococcosis↗

PubMedDate not supplied

A case of liver echinococcosis mimicing a solid liver tumor.

A case of hepatic echinococcosis mimicing a solid tumor was presented. The echinococcosis appeared as an echogenic mass in US, a low density area in CT, and an area of low (T1-weighted image) and high (T2-weighted image) intensity in MRI. Echo-guided biopsy showed PAS-positive cuticle layer of echinococcus in the necrotic tissue. Anular features around the lesion noted in MRI seemed to imply increased hepatic tissue water (congestion and/or edema). When a solid tumor is noted in the liver, proper history taking and awareness of this disease will decrease the chance of misdiagnosis.

Adenoma, Bile Duct↗

PubMed2006

Cystic echinococcosis: progress and limits in epidemiology and immunodiagnosis.

This study discusses the epidemiology and immunodiagnosis of cystic echinococcosis (caused by Echinococcus granulosus). Despite the development of molecular methods to prepare antigens, nowadays there is no standard, highly sensitive, and specific test available for antibody detection in cystic echinococcosis. Furthermore, because serological tests can give only a limited support to clinical findings there is a clear need for new advances in immunodiagnosis of E. granulosus infection.

Animals↗

PubMed2006

[Primary cardiac echinococcosis].

Cardiac echinococcosis is very rare, even in endemic regions. It has been reported that cardiac involvement is seen in about 0.5-3% of human echinococcosis cases. A case of cardiac isolated hydatid desease that caused sporadic syncopal episodes is illustrated.

Adult↗

PubMed1991

[Surgical treatment of hepatic echinococcosis using carbon dioxide laser].

The results of using the laser scalpel in surgery for echinococcosis of the liver in 68 patients are discussed. It was established that carbon dioxide laser induces coagulation of small blood vessels and intrahepatic bile ducts and thus prevents postoperative complications like bleeding and escape of bile, destroys live protoscoleces, and has a harmful effect on the microflora. This creates favourable conditions for shortening the period of treatment for patients with echinococcosis.

Carbon Dioxide↗

PubMed1991

[Echinococcosis of the spleen. Its conservative surgical treatment].

Echinococcosis cysts in the spleen are very rare, even in endemic areas. We report here on 4 patients (0.5% of the total number of cases of echinococcosis disease) who have been treated in the University Hospital Granada from 1970 to 1990. Formerly, splenectomy was for most surgeons the recommended surgical procedure. From 1980, however, most authors have rejected such a radical procedure and most now recommend conservative surgery of the spleen. We have always followed this conservative procedure, as of course in cases of liver echinococcus, that is: cyst enucleation and marcupialisation (Posadas-Dew method), if there are no cyst complications. And in cases of infected or suppurating cysts we used drainage-marsupialisation. We have obtained very good results: no mortality was recorded.

Adolescent↗

PubMedDate not supplied

Myocardial echinococcosis with perforation into the pericardium.

Though rare, cardiac echinococcosis should be included in the differential diagnosis of cardiac tumors, particularly in patients originating from endemic areas or with manifestation of hydatid disease in other organs. Diagnosis and localisation of the cysts is best accomplished with non-invasive methods such as 2-D transthoracic and transesophageal echocardiography, computed tomography and NMR. Excision of the cardiac cyst from the interventricular septum in a 21 year old patient with polyvisceral echinococcosis was performed with cardiopulmonary bypass. Adjunctive medical therapy with mebendazol is being continued for 24 months postoperatively. Twelve months after surgery the patient is asymptomatic without echocardiographic signs of recurrence.

Adult↗

PubMed1991

[The diagnostic value of echography in hepatic echinococcosis].

The ultrasound method of examination led to revolutionary changes in the diagnosis of liver echinococcosis [correction of Echinococcus]. The ultrasound image of this disease, which is common in the region, is presented. The ultrasound method is compared with other diagnostic methods and its importance is pointed out. The ultrasound method of examination is a reliable means for the diagnosis of liver echinococcosis [correction of Echinococcus].

Adolescent↗

PubMed1990

[Characteristics of angiohepatography using an oily contrast medium in the diagnosis of hepatic echinococcosis].

A comparative assessment of different methods of angiography for diagnostics of echinococcosis of the liver is given. Conditions of prolonged contrast of vessels and parenchyma of the organ were created by splenoportography and arteriography of the liver with maiodyl which allows to determine the presence and degree of morphofunctional changes and spread of the pathological process in echinococcosis of the liver.

Contrast Media↗

PubMed1991

Orthotopic liver transplantation for incurable alveolar echinococcosis of the liver: report of 17 cases.

Between 1986 and 1989, orthotopic liver transplantations were performed in our unit for 17 patients with incurable alveolar echinococcosis. Ten patients had hilar involvement (group I), and seven patients had posterior localization (five of them had chronic Budd-Chiari syndrome) (group II). The delay between diagnosis and the orthotopic liver transplantation was more than 48 mo in group Ia (six patients), less than 24 mo in group Ib (four patients) and less than 48 mo in group II. Previous operations were more common in group Ia than in group Ib and II. Five patients have died-four in group I and one in group II. The actuarial survival rate at 15 mo was 75%. Early reoperations were frequent (69%), mainly caused by rebleeding. Bacterial and fungal infections occurred only in group Ia (four cases) and group II (three cases). In eight patients (palliative group), residual foci of infected nonhepatic tissue occurred after surgery. The titer of specific antibodies decreased during the first 3 mo in all the patients but one. In patients with radical liver transplantation, the complete disappearance of specific antibodies occurred within 2 yr in four cases. In the remaining five patients, specific antibodies remained detectable, but no evidence of recurrence has been obtained up to now. In the palliative group, a peak of specific IgM occurred at 3 mo; an increase of specific IgG was observed later. The growth of residual parasitic foci was relatively slow, and all these patients remained asymptomatic with a mean follow-up of 19 mo. We conclude that orthotopic liver transplantation is feasible in incurable alveolar echinococcosis and could be proposed without delay to patients with parasitic Budd-Chiari syndrome or complicated secondary biliary cirrhosis. In the other cases, the best time to perform an orthotopic liver transplantation is more difficult to determine. Nevertheless, in the perspective of an orthotopic liver transplantation, the management of these patients has to change, and repetitive laparotomies for palliative surgical procedures have to be replaced by interventional radiology.

Adult↗