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The approach to stool examination for parasites.

This article presents the sequences followed in order to maximize the yield of laboratory assistive diagnosis of parasitic infections in the physiologic passage and/or collection of specimens for those parasites producing pathologic disease in the gastrointestinal tract and liver. The advantages and disadvantages of the many methods available to the clinician and laboratorian in the examination of those specimens are presented in a work-flow mode. The controversy relative to the current practice of controlling unwarranted specimen submission and the reasons for their rejection of limited examination and interpretation are discussed. Quality assurance and safety practices are also addressed.

Coloring Agents↗

Duplex hemodynamic evaluation of hepatosplenic mansoni schistosomiasis.

Conventional ultrasonography highly contributes to a non invasive diagnosis of HS schistosomiasis (Cerri et al., 1984). The introduction of Doppler allowed new advances in the knowledge of the portal dynamics of this disease (Taylor et al. 1985; Moriyasu et al., 1986). The aim of this paper was to analyze the hemodynamic behavior of the portal vessels, considering caliper, maximum flow speed, direction of flow and preferential disposition of the collateral vessels. Thirty two patients with schistosomiasis mansoni with confirmed hepatosplenic form (HSSM), were analyzed. Fourteen patients with the intestinal form, have been analyzed as a control group. The results demonstrated that the maximum speed of the portal vein in the two groups has not been significantly different. Nevertheless, the diameter of the PV in the hepatosplenic group has been larger. The splenic vein presented speed and caliper larger than the superior mesenteric vein. The hepatic artery has been detected in only 40% of the cases. The hepatic veins presented normal caliper and spectral pattern. The duplex proved to be an useful technic complementary and non-invasive, in the study of HSSM.

Adolescent↗

[Hepatic schistosomiasis: diagnostic difficulties in a non endemic area].

Schistosomiasis is a major cause of liver damage and portal hypertension, especially in tropical countries, affecting about 200 million people in the world. We report the cases of two patients presenting persistent alterations of serum liver enzymes. We enhance the importance of considering the history of past travels and a liver biopsy to diagnose an infrequent parasite induced liver disease in a non endemic area such as Portugal. Some observations are made about the diagnosis and treatment of this parasitic disease.

Biopsy↗

[Hepatectomy in repeated operations on patients with parasitic diseases of the liver].

The results of resection of the liver in repeated operations on patients with parasitic disease of the liver are discussed. Operations were conducted on 22 patients with alveococcosis and 7 patients with echinococcosis. By means of the method of atypical liver resection radical operations were performed on 20 patients (69%) and palliative resections of the liver in 9 patients (31%). The palliative resections were combined with cryodestruction of the remaining parasitic tissue, which improved the therapeutic effect significantly and prolonged the patients' survival. The volume of the resection ranged from a segment to one half of the liver. The fatality rate was 6.8%.

Adult↗

Parasitic cysts of the liver - practical approach to diagnosis and differentiation.

BACKGROUND: The aim of the study was to determine the incidence of parasitic liver cysts. MATERIAL AND METHODS: In 1996-2000 at the Department of Infectious Diseases parasitic liver cysts were diagnosed in 31 patients. The diagnosis was based on imaging examinations (ultrasound, computerised tomography), serological reactions (ELISA, IHA) and histopathological investigation of the specimens obtained through fine-needle aspiration biopsy. RESULTS AND CONCLUSION: The latter followed the pre-treatment with antiparasitic drug and no significant complications were observed. On the basis of the criteria developed by our team (evident, highly probable and probable diagnosis), hydatid disease of the liver was diagnosed in 8 patients (25.8%). The remaining subjects, excluding one patient who underwent surgical treatment, received repeated treatment with imidazole derivatives (Zentel or Vermox).

Biopsy, Needle↗