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Shafiei R, Mohajerzadeh MS, Masomi HFA, Tavakoli M, Turki H, Firouzeh N. Discordance Therapeutic Protocol of Cystic Echinococcosis With WHO Guideline: A Descriptive Study Based on Liver Ultra-Sonographic Data in North Khorasan Province, Northeastern of Iran. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1279-1287. [PMID: 38497687 DOI: 10.1002/jum.16452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Cystic echinococcosis (CE), a helminth-associated zoonosis caused by Echinococcus granulosus, poses a significant public health problem, particularly in pastoral-rearing regions. The lack of uniform guidelines led to variations in CE management. Based on ultrasound data, the World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) classification system categorizes cysts into active, transitional, and inactive groups. This study assesses whether the therapeutic approach from liver human operation cases in North Khorasan province aligns with the WHO-IWGE reference based on ultrasound data. METHODS The research is based on ultrasound data from liver CE human operation cases collected between 2018 and 2022. This retrospective study investigates the therapeutic protocol for (CE) in North Khorasan Province, Iran, comparing it with the WHO-IWGE guidelines. We collect data from previously registered patients' medical information from our studied area's main CE surgical hospital. Moreover, as the first hospitalized survey in Iran, this study reveals insights into patient demographics, cyst stage prevalence, and treatment modalities. RESULTS Notably, more than half of the patients were treated for CE1 stage cysts, and CE4 cases, which generally do not require surgery, underwent open surgery. The results suggest a need for adherence to the "watch-and-wait" approach in specific cases. All patients underwent successful surgeries, but we do not have access to follow-up data from patients after discharge. CONCLUSIONS This descriptive study contributes to understanding the implementation of WHO guidelines in a regional context, shedding light on the challenges and variations in CE management. It seems, retraining courses for surgeons are required to update their knowledge of standard CE diagnostic and treatment methods.
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Affiliation(s)
- Reza Shafiei
- Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mina Sadat Mohajerzadeh
- Department of Radiology and Medical Physics, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | | | - Maryam Tavakoli
- Department of Radiology and Medical Physics, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Habibollah Turki
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nima Firouzeh
- Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Manterola C, Rivadeneira J, Rojas-Pincheira C, Otzen T, Delgado H, Sotelo C, Sanhueza A. Cholangiohydatidosis. Clinical features, postoperative complications and hospital mortality. A systematic review. PLoS Negl Trop Dis 2024; 18:e0011558. [PMID: 38452054 PMCID: PMC10950226 DOI: 10.1371/journal.pntd.0011558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 03/19/2024] [Accepted: 02/14/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Cholangiohydatidosis (CH) is an evolutionary complication of hepatic cystic echinococcosis, associated with increased morbidity and mortality. The aim of this study was to describe the available evidence regarding clinical characteristics of CH, postoperative complications and hospital mortality. METHODOLOGY/PRINCIPAL FINDINGS Systematic review. Studies related to CH with no language or publication restriction were included. Sensitive searches were performed in Trip Database, SciELO, BIREME-BVS, WoS, PubMed, EMBASE and SCOPUS. MeSH and free terms were used, including articles up to April 2023. The main outcome variables were postoperative complications and hospital mortality; the secondary ones were publication year, origin and design of primary studies, main clinical manifestation, anatomical location and type of cysts, hospital stay, surgical procedure performed, reinterventions; and methodological quality of primary studies, which was assessed using MInCir-T and MInCir-P scales. Descriptive statistics, calculation of weighted averages and their comparison by least squares logistic regression were applied. 446 studies were retrieved from the searches performed, 102 of which met the inclusion and exclusion criteria. The studies analyzed represent 1241 patients. The highest proportion of articles was published in the last decade (39.2%). Reports are mainly from Turkey (28.4%), Greece (9.8%), Morocco and Spain (8.8% each). With a weighted mean of 14.3 days of hospital stance; it was verified that 26.2% of patients developed postoperative complications (74,3% Clavien y Dindo III y IV), 6.7% needed re-interventions, and 3.7% died. When comparing the variables age, postoperative complications, hospital mortality, and reinterventions in two periods of time (1982-2006 vs. 2007-2023), no statistically significant differences were found. When applying the MInCir-T and MInCir-P scales, the methodological quality of the primary studies was 9.6±1.1 and 14.5±4.3 points, respectively. CONCLUSION/SIGNIFICANCE CH is associated with severe postoperative complications and significant hospital mortality, independent of the development of therapeutic support associated with the passage of time.
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Affiliation(s)
- Carlos Manterola
- Center for Morphological and Surgical Studies. Universidad de La Frontera. Chile
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
| | - Josue Rivadeneira
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
- Zero Biomedical Research. Quito, Ecuador
| | - Claudio Rojas-Pincheira
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
| | - Tamara Otzen
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
| | - Hugo Delgado
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
| | | | - Antonio Sanhueza
- Pan American Health Organization, Washington, United States of America
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Shahriarirad R, Shekouhi R, Erfani A, Rastegarian M, Eskandarisani M, Motamedi M, Sarkari B. Evaluation of the features of cystic echinococcosis with concurrent super-infection: a retrospective study in Southern Iran. BMC Infect Dis 2023; 23:525. [PMID: 37563707 PMCID: PMC10413494 DOI: 10.1186/s12879-023-08520-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/08/2023] [Indexed: 08/12/2023] Open
Abstract
OBJECTIVE Superinfection of cystic echinococcosis (CE) is a life-threatening complication with significant morbidities, which can be prevented with early diagnosis and treatment. This study aims to examine the clinical characteristics, diagnostic methods, and treatment options for superinfected CE, as there is currently limited information available on the differences between superinfected and non-infected CE in terms of clinical features, serological and radiologic findings. METHODS This cross-sectional study was conducted on hospital records of patients who were diagnosed with hydatid cysts in a 15-year period (2004 to 2018) in two main university-affiliated referral centers in Fars province, southern Iran. Patients' information regarding the demographical and clinical features related to CE, age, sex, previous history of CE or recurrence, size and location of CE, and length of hospital stay were collected. Moreover, the characteristics of concurrent infections with hydatid cysts were recorded. RESULTS A total of 586 surgeries due to CE were performed on 501 patients, of which 67 (11.43%) had reoperations due to the recurrence of the disease. A total of 30 (5.99%) incidences of superinfection were observed. There were no statistically significant differences in terms of laboratory and imaging findings between CE patients with concurrent infections and other CE patients (p-value > 0.05). Among the patients with super-infection, four had fungal infections of the lungs. Aspergillus fumigatus was the causative pathogen in all four patients that were diagnosed with fungal superinfection. All patients underwent surgical excision with favorable long-term outcomes. CONCLUSION Our study revealed a 5.99% incident rate of CE superinfection. Regarding the concurrent fungal infections in hydatid cysts, the patient's symptoms and laboratory and imaging findings are inconclusive and histopathological evaluation seems to be the most reliable option. Surgical resection is the gold-standard treatment option with favorable outcomes and potentially can be curative.
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Affiliation(s)
- Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Shekouhi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Erfani
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Marjan Motamedi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahador Sarkari
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Science, Shiraz, Iran.
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GONZÁLEZ-ARBOLEDA F, PIZARRO F, LINDNER C, CAQUEO F. THERAPEUTIC APPROACH OF COMPLICATED HYDATID DISEASE: ROLE OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN CHOLANGIOHYDATIDOSIS. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2023; 35:e1699. [PMID: 36629682 PMCID: PMC9831634 DOI: 10.1590/0102-672020220002e1699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/11/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Hydatid disease, a parasitic infestation caused by Echinococcus granulosus larvae, is an infectious disease endemic in different areas, such as India, Australia, and South America. The liver is well known as the organ most commonly affected by hydatid disease and may present a wide variety of complications such as hepatothoracic hydatid transit, cyst superinfection, intra-abdominal dissemination, and communication of the biliary cyst with extravasation of parasitic material into the bile duct, also called cholangiohydatidosis. Humans are considered an intermediate host, exposed to these larvae by hand-to-mouth contamination of the feces of infected dogs. AIM This study aimed to highlight the role of endoscopic retrograde cholangiopancreatography in patients with acute cholangitis secondary to cholangiohydatidosis. METHODS Considering the imaging findings in a 36-year-old female patient with computed tomography and magnetic resonance imaging showing a complex cystic lesion in liver segment VI, with multiple internal vesicles and a wall defect cyst that communicates with the intrahepatic biliary tree, endoscopic biliary drainage was performed by endoscopic retrograde cholangiopancreatography with papillotomy, leading to the discharge of multiple obstructive cysts and hydatid sand from the main bile duct. RESULTS Clinical and laboratory findings improved after drainage, with hospital discharge under oral antiparasitic treatment before complete surgical resection of the hepatic hydatid cyst. CONCLUSIONS Endoscopic retrograde cholangiopancreatography is a safe and useful method for the treatment of biliary complications of hepatic hydatid disease and should be considered the first-line procedure for biliary drainage in cases of cholangiohydatid disease involving secondary acute cholangitis.
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Affiliation(s)
- Franz GONZÁLEZ-ARBOLEDA
- Regional Hospital, Digestive Surgery Department – Talca, Chile;,Catholic University of Maule, Faculty of Medicine – Talca, Chile
| | | | - Cristian LINDNER
- Regional Hospital, Digestive Surgery Department – Talca, Chile;,Regional Hospital, Radiology Department – Talca, Chile
| | - Fermín CAQUEO
- Regional Hospital, Digestive Surgery Department – Talca, Chile
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Yang J, Wang M, Yang J, Chu Z, Chen X, Wu X, Peng X. Calcifying nanoparticles initiate the calcification process of mesenchymal stem cells in vitro through the activation of the TGF-β1/Smad signaling pathway and promote the decay of echinococcosis. Open Life Sci 2022. [DOI: 10.1515/biol-2022-0503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
The role of the calcifying nanoparticles (CNPs) in the calcification process of the outer cyst wall in hepatic cystic echinococcosis (HCE) remains unknown. CNPs were isolated from the tissues of the patients with HCE. Western blotting, alkaline phosphatase staining, and alizarin staining were performed to detect the cellular calcium ion deposition induced by the CNPs. CCK-8 and flow cytometry assays were conducted to determine the effect of CNPs on the apoptosis of mesenchymal stem cells (MSCs). Western blot experiments were performed to examine the expression levels of apoptosis-related factors and TGF-β1/Smad signaling pathway constituents. Treatment with CNPs induced the differentiation of MSCs. Calcium-related proteins, including OPN, BMP-2, and RUNX2, were upregulated after the CNP treatment. Similarly, CNP exposure increased the cellular calcium ion deposition in MSCs. In addition, the expression of Bax and Caspase-8 was elevated by the CNPs in MSCs. Treatment with CNPs promoted MSC apoptosis and inhibited the MSC growth. The TGF-β1/Smad signaling pathway was also activated after the CNP treatment. This study indicated that CNPs may play a critical role in initiating calcification of the outer cyst wall of HCE and promote the decay of echinococcosis, providing a new strategy for the treatment of hepatic echinococcosis.
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Affiliation(s)
- Jian Yang
- Center of Hepatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , 430030 , China
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Medical College, Shihezi University , No. 107, North Second Road , Shihezi , 832008, Xinjiang , China
| | - Meiyan Wang
- Department of Nursing, Shihezi University School of Medicine , Shihezi , 832000, Xinjiang , China
| | - Jing Yang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Medical College, Shihezi University , No. 107, North Second Road , Shihezi , 832008, Xinjiang , China
| | - Zhiqiang Chu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Medical College, Shihezi University , No. 107, North Second Road , Shihezi , 832008, Xinjiang , China
| | - Xueling Chen
- Department of Immunology, Shihezi University School of Medicine , Shihezi , 832000, Xinjiang , China
| | - Xiangwei Wu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Medical College, Shihezi University , No. 107, North Second Road , Shihezi , 832008, Xinjiang , China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Ministry of Education, Shihezi University School of Medicine , Shihezi , Xinjiang, 832000 , China
- NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, First Affiliated Hospital, School of Medicine, Shihezi University , Shihezi , 832000, Xinjiang , China
| | - Xinyu Peng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Medical College, Shihezi University , No. 107, North Second Road , Shihezi , 832008, Xinjiang , China
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García-Méndez N, Manterola C, Totomoch-Serra A, Riffo-Campos AL, Brito-Carreón CA. PROTEOMIC PROFILE OF ECHINOCOCCUS GRANULOSUS: A SYSTEMATIC REVIEW. J Parasitol 2022; 108:64-69. [PMID: 35119469 DOI: 10.1645/20-86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cystic echinococcosis is a zoonotic disease caused by the larval stage of Echinococcus granulosus. This affliction is an endemic worldwide condition that represents a neglected parasitic disease with important socioeconomic repercussions. Proteomic characterization of larval and adult stages of E. granulosus, as well as the association between expression profiles and host interactions, is relevant for a better understanding of parasite biology, and eventually for drug design and vaccine development. This study aimed to develop a synthesis of the evidence available related to proteomics of E. granulosus. A systematic review was carried out to collect data concerning the proteomics of E. granulosus, without language or host restriction, published between 1980 and 2019. A systematic search was carried out in the Trip Database, BIREME-BVS, SciELO, Web of Science, PubMed, EMBASE, SCOPUS, EBSCO host, and LILACS, using MeSH terms, free words, and Boolean connectors, and adapting strategies to each source of information. Additionally, a manual cross-reference search was performed. Variables studied were the year of publication, geographic origin of the study, number of samples, hosts, parasitic organs, proteomic techniques, and parasite proteins verified. Nine-hundred and thirty-six related articles were identified: 17 fulfilled selection criteria, including slightly more than 188 samples. Most articles were published between 2014 and 2019 (64.7%) and were from Brazil and China (35.3% each). In reference to confirmed hosts in the primary articles, cattle (41.2%) and humans (23.5%) were the most frequently reported. Concerning proteomic techniques applied in the primary articles, LC-MS/MS was the most used (41.1%), and 890 proteins were reported by the primary articles. As the results of our search suggest, the information related to E. granulosus proteomics is scarce, heterogeneous, and scattered throughout several articles that include a diversity of tissues, samples, intermediate hosts, and proteomic techniques. Consequently, the level of evidence generated by our search is type 4.
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Affiliation(s)
- Nayely García-Méndez
- Ph.D. Program in Medical Sciences, Universidad de La Frontera, 4811230, Temuco, Chile
| | - Carlos Manterola
- Ph.D. Program in Medical Sciences, Universidad de La Frontera, 4811230, Temuco, Chile.,Center of Excellence in Morphological and Surgical Studies (CEMyQ), Universidad de La Frontera, 4811230, Temuco, Chile
| | - Armando Totomoch-Serra
- Ph.D. Program in Medical Sciences, Universidad de La Frontera, 4811230, Temuco, Chile.,Department of Genetics and Molecular Biology, Center for Research and Advanced Studies, National Polytechnic Institute, 36824, México City, México
| | - Angela L Riffo-Campos
- Ph.D. Program in Medical Sciences, Universidad de La Frontera, 4811230, Temuco, Chile
| | - César A Brito-Carreón
- Department of Genetics and Molecular Biology, Center for Research and Advanced Studies, National Polytechnic Institute, 36824, México City, México
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Shabunin AV, Tavobilov MM, Karpov AA. [Echinococcosis of the liver: evolution of surgical treatment]. Khirurgiia (Mosk) 2021:95-103. [PMID: 33977704 DOI: 10.17116/hirurgia202105195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To analyze the development of surgical approaches for hepatic echinococcosis. MATERIAL AND METHODS We have analyzed diagnosis and treatment of 349 patients with liver echinococcosis; 97 patients were treated at the Botkin Clinical Hospital for the period from 2009 to 2019 and 252 patients were treated in surgical hospitals of Moscow city for the period from 2014 to 2019. RESULTS General and specific postoperative complications, relapses and surgical approaches were assessed. The number of echinococcectomies performed in surgical hospitals of Moscow is 3 times higher compared to the Botkin Hospital. The number of liver resections is comparable in both groups. The number of pericystectomies is more than 2 times higher in the Botkin Hospital. PAIR technique was more common in surgical hospitals of Moscow. CONCLUSION Evolution of surgical treatment from open echinococcectomy to anatomical liver resections and subsequent pericystectomy with PAIR technique becomes another round of evolutionary spiral in the development of surgical treatment of liver echinococcosis.
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Affiliation(s)
- A V Shabunin
- Botkin Clinical Hospital, Moscow, Russia.,Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
| | - M M Tavobilov
- Botkin Clinical Hospital, Moscow, Russia.,Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
| | - A A Karpov
- Botkin Clinical Hospital, Moscow, Russia
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