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Ammar A, Riahi H, Chaabouni M, Venturelli N, Renault V, Dray B, Safa D, Abid L, Bouaziz MC, Carlier RY. The multifaceted musculoskeletal hydatid disease. Skeletal Radiol 2024; 53:2181-2194. [PMID: 38483570 DOI: 10.1007/s00256-024-04644-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/25/2024] [Accepted: 03/05/2024] [Indexed: 09/05/2024]
Abstract
Musculoskeletal hydatid disease is rare and can be located anywhere but most commonly the bone and muscles of the spine, pelvis, then the lower limbs. Imaging is essential for its diagnosis, performing the pre-therapeutic assessment, guiding possible percutaneous treatments, and providing post-therapeutic follow-up. Musculoskeletal hydatidosis can take several forms that may suggest other infections and tumors or pseudotumors. MRI and CT are superior for its diagnosis but ultrasound and radiography remain the most accessible examinations in developing countries where this parasitosis is endemic. In this review, we provide an overview of this disease and describe its different imaging patterns in soft tissue and bone involvement that should be sought to support the diagnosis.
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Affiliation(s)
- Amine Ammar
- Department of Radiology, Hôpital Raymond-Poincaré - APHP - DMU Smart Imaging - GH Université Paris-Saclay (U 1179 UVSQ/Paris-Saclay), 104 Boulevard Raymond Poincaré, 92380, Garches, France.
| | - Hend Riahi
- Department of Radiology, MT Kassab Institute of Orthopaedics - Faculty of Medicine of Tunis - Tunis-El Manar University, Ksar Saïd - Manouba, 2010, Tunis, Tunisia
| | - Mohamed Chaabouni
- Department of Radiology, MT Kassab Institute of Orthopaedics - Faculty of Medicine of Tunis - Tunis-El Manar University, Ksar Saïd - Manouba, 2010, Tunis, Tunisia
| | - Nadia Venturelli
- Department of Radiology, Hôpital Raymond-Poincaré - APHP - DMU Smart Imaging - GH Université Paris-Saclay (U 1179 UVSQ/Paris-Saclay), 104 Boulevard Raymond Poincaré, 92380, Garches, France
| | - Valentin Renault
- Department of Radiology, Hôpital Raymond-Poincaré - APHP - DMU Smart Imaging - GH Université Paris-Saclay (U 1179 UVSQ/Paris-Saclay), 104 Boulevard Raymond Poincaré, 92380, Garches, France
| | - Benjamen Dray
- Department of Radiology, Hôpital Raymond-Poincaré - APHP - DMU Smart Imaging - GH Université Paris-Saclay (U 1179 UVSQ/Paris-Saclay), 104 Boulevard Raymond Poincaré, 92380, Garches, France
| | - Dominique Safa
- Department of Radiology, Hôpital Raymond-Poincaré - APHP - DMU Smart Imaging - GH Université Paris-Saclay (U 1179 UVSQ/Paris-Saclay), 104 Boulevard Raymond Poincaré, 92380, Garches, France
| | - Leila Abid
- Department of Pathology, MT Kassab Institute of Orthopaedics - Faculty of Medicine of Tunis - Tunis-El Manar University, Ksar Saïd - Manouba, 2010, Tunis, Tunisia
| | - Mouna Chelli Bouaziz
- Department of Radiology, MT Kassab Institute of Orthopaedics - Faculty of Medicine of Tunis - Tunis-El Manar University, Ksar Saïd - Manouba, 2010, Tunis, Tunisia
| | - Robert-Yves Carlier
- Department of Radiology, Hôpital Raymond-Poincaré - APHP - DMU Smart Imaging - GH Université Paris-Saclay (U 1179 UVSQ/Paris-Saclay), 104 Boulevard Raymond Poincaré, 92380, Garches, France
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Zhu D, Abuduhelili A, Tulahong A, Liu C, Jiang T, Shao Y, Aji T. A special case of intrahepatic cholangiocarcinoma misdiagnosed as hepatic cystic echinococcosis. Heliyon 2024; 10:e35073. [PMID: 39161843 PMCID: PMC11332812 DOI: 10.1016/j.heliyon.2024.e35073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 07/10/2024] [Accepted: 07/22/2024] [Indexed: 08/21/2024] Open
Abstract
Intrahepatic cholangiocarcinoma (iCCA) is a prevalent liver tumor that presents a diagnostic challenge due to its nonspecific symptoms, necessitating reliance on imaging techniques for accurate diagnosis. The similarity of imaging features with other liver diseases, such as hepatocellular carcinoma (HCC) and hepatic alveolar echinococcosis, often leads to confusion and misdiagnosis. In contrast, the distinct characteristics of hepatic cystic echinococcosis (HCE) result in fewer reported misdiagnoses. A case involving a 53-year-old female from Changji (Xinjiang, China) diagnosed with iCCA, who was hospitalized for symptoms of upper abdominal distension and pain, along with nausea and vomiting, is presented. The patient underwent a partial hepatectomy in 1990 for hepatic echinococcosis. Abdominal computed tomography revealed multiple, quasicircular, low-density masses in the hilar region and right anterior lobe of the liver, with the largest measuring 5.61 cm × 4.84 cm. Enhanced computed tomography did not reveal significant enhancement of the lesion. Considering epidemiological factors, medical history, and imaging findings, the initial diagnosis was HCE, which prompted surgical intervention. The diagnosis of iCCA with necrosis was confirmed via pathological examination. The literature and relevant sources were consulted to establish that biliary tract tumors with necrosis or mucin production typically do not exhibit significant enhancement in enhanced scans, maintaining a consistently low density across all phases, resembling the presentation of HCE. When making diagnoses based on imaging data, it is essential to have knowledge of both the typical features and unique manifestations of the disease. In specific instances, relying solely on epidemiology and medical history may lead to incorrect conclusions. Therefore, comprehensive consideration of all aspects is necessary to prevent missed diagnoses and misdiagnoses.
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Affiliation(s)
- Dalong Zhu
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
- Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
| | - Abuduhaiwaier Abuduhelili
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
- Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
| | - Alimu Tulahong
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
- Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
| | - Chang Liu
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
| | - Tiemin Jiang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
- Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
| | - Yingmei Shao
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
- Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
| | - Tuerganaili Aji
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
- Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China
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Luo X, Jiang P, Ma J, Li Z, Zhou J, Wei X, A J, Chai J, Lv Y, Cheng P, Cao C, A X. Circulating free DNA as a diagnostic marker for echinococcosis: a systematic review and meta-analysis. Front Microbiol 2024; 15:1413532. [PMID: 39021627 PMCID: PMC11251952 DOI: 10.3389/fmicb.2024.1413532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 06/10/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Echinococcosis is a chronic zoonotic disease caused by tapeworms of the genus Echinococcus. The World Health Organization (WHO) has identified encapsulated disease as one of 17 neglected diseases to be controlled or eliminated by 2050. There is no accurate, early, non-invasive molecular diagnostic method to detect echinococcosis. The feasibility of circulating free DNA as a diagnostic method for echinococcosis has yielded inconclusive results in a number of published studies. However, there has been no systematic evaluation to date assessing the overall performance of these assays. We report here the first meta-analysis assessing the diagnostic accuracy of cfDNA in plasma, serum, and urine for echinococcosis. Methods We systematically searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WeiPu databases up to 17 January 2024, for relevant studies. All analyses were performed using RevMan 5.3, Meta-DiSc 1.4, Stata 17.0, and R 4.3.1 software. The sensitivity, specificity, and other accuracy indicators of circulating free DNA for the diagnosis of echinococcosis were summarized. Subgroup analyses and meta-regression were performed to identify sources of heterogeneity. Results A total of 7 studies included 218 patients with echinococcosis and 214 controls (156 healthy controls, 32 other disease controls (non-hydatid patients), and 26 non-study-targeted echinococcosis controls were included). Summary estimates of the diagnostic accuracy of cfDNA in the diagnosis of echinococcosis were as follows: sensitivity (SEN) of 0.51 (95% CI: 0.45-0.56); specificity (SPE) of 0.99 (95% CI: 0.97-0.99); positive likelihood ratio (PLR) of 11.82 (95% CI: 6.74-20.74); negative likelihood ratio (NLR) of 0.57 (95% CI: 0.41-0.80); diagnostic ratio (DOR) of 36.63 (95% CI: 13.75-97.59); and area under the curve (AUC) value of 0.98 (95% CI: 0.96-1.00). Conclusion Existing evidence indicates that the combined specificity of circulating cfDNA for echinococcosis is high. However, the combined sensitivity performance is unsatisfactory due to significant inter-study heterogeneity. To strengthen the validity and accuracy of our findings, further large-scale prospective studies are required.Systematic review registrationThe systematic review was registered in the International Prospective Register of Systematic Reviews PROSPERO [CRD42023454158]. https://www.crd.york.ac.uk/PROSPERO/.
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Affiliation(s)
- Xiaoqin Luo
- Qinghai University, Xining, China
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
| | | | | | - Zian Li
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
| | - Jianwu Zhou
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
| | | | - Jide A
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
| | - Jinping Chai
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
| | - Yanke Lv
- Qinghai University, Xining, China
| | | | | | - Xiangren A
- Qinghai University, Xining, China
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
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Tian T, Miao L, Wang W, Zhou X. Global, Regional and National Burden of Human Cystic Echinococcosis from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. Trop Med Infect Dis 2024; 9:87. [PMID: 38668548 PMCID: PMC11054543 DOI: 10.3390/tropicalmed9040087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/21/2024] [Accepted: 04/02/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is a neglected tropical parasitic disease that poses huge disease, social and economic burdens worldwide; however, there has been little knowledge on the global morbidity, mortality and disability-adjusted life years (DALYs) of CE until now. This study aimed to collect the most up-to-date data about the global, regional and national disease burden due to CE from 1990 to 2019 and to project trends in the next 10 years. METHODS We measured the global, regional and national morbidity, mortality and DALYs of CE from 1990 to 2019 based on the Global Burden of Disease Study 2019 (GBD 2019) data, and we examined the correlation between socioeconomic development levels and the disease burden of CE. In addition, the disease burden due to CE was projected from 2020 to 2030. RESULTS The age-standardized incidence rate (ASIR) of CE reduced from 2.65/105 [95% UI: (1.87/105 to 3.7/105)] in 1990 to 2.6/105 [95% UI: (1.72/105 to 3.79/105)] in 2019 (EAPC = -0.18%). The number of deaths, DALYs, age-standardized mortality rate (ASMR) and age-standardized DALY rate due to CE all showed a tendency to decline from 1990 to 2019. A higher disease burden of CE was measured in women than in men in 2019. There was a significant difference in the ASMR of CE by region according to the socio-demographic index (SDI), and lower burdens of CE were estimated in high-SDI regions. The global ASIR of CE is projected to decline from 2020 to 2030; however, the ASMR and age-standardized DALY rate are projected to rise. CONCLUSIONS The global burden of CE remains high, and it is recommended that more health resources are allocated to low-SDI regions, women and the elderly aged 55 to 65 years to reduce the disease burden of CE.
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Affiliation(s)
- Tian Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), WHO Collaborating Centre for Tropical Diseases, National Health Commission Key Laboratory of Parasite and Vector Biology, National Center for International Research on Tropical Diseases, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Shanghai 200025, China;
| | - Liyuan Miao
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
- One Health Center, Shanghai Jiao Tong University—The University of Edinburgh, Shanghai 200025, China
| | - Wei Wang
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China;
| | - Xiaonong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), WHO Collaborating Centre for Tropical Diseases, National Health Commission Key Laboratory of Parasite and Vector Biology, National Center for International Research on Tropical Diseases, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Shanghai 200025, China;
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
- One Health Center, Shanghai Jiao Tong University—The University of Edinburgh, Shanghai 200025, China
- Hainan Center for Tropical Diseases Research, Haikou 571199, China
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Yang Z, Liu K, Wen B, Fu T, Qin X, Li R, Lu M, Wang Y, Zhang W, Shao Z, Long Y. Changes in the global epidemiological characteristics of cystic echinococcosis over the past 30 years and projections for the next decade: Findings from the Global Burden of Disease Study 2019. J Glob Health 2024; 14:04056. [PMID: 38547498 PMCID: PMC10978057 DOI: 10.7189/jogh.14.04056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
Background Despite ongoing changes in the global epidemiology of cystic echinococcosis (CE), there is a lack of research conducted to date. Methods We extracted data on incidence and disability-adjusted life years for 204 countries and territories from 1990 to 2019 to evaluate the epidemiological characteristics and burden of CE through the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. We used locally weighted linear regression to analyse the primary driving factors of the prevalence of CE at the national and regional levels and utilised a Bayesian Age-Period-Cohort model to forecast the global incidence of CE in the next decade. Results Globally, the incidence of CE remained constantly high from 1990 (2.65 per 100 000 population) to 2019 (2.60 per 100 000 population), resulting in an estimated 207 368 new cases in 2019. We observed substantial variations in the disease burden regarding its spatiotemporal distribution, population demographics, and Socio-Demographic Index levels. According to established models, factors such as health care capacity, livestock husbandry, agricultural activities, rural populations, and education levels are likely to play significant roles in determining the prevalence of CE across different countries. By 2030, the worldwide number of CE cases could reach as high as 235 628, representing an increase of 13.63% compared to 2019. Conclusions Over the past three decades, the global burden of CE has persistently remained high, especially in Central Asia, as well as North Africa and the Middle East. Efforts should focus on more effective prevention and control measures in these key regions and should specifically target vulnerable populations to prevent the escalation of epidemics.
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Affiliation(s)
- Zurong Yang
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
- Centre for Disease Prevention and Control in Northern Theater Command, Shenyang, China
| | - Kun Liu
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Bo Wen
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
- Lintong Rehabilitation and Convalescent Centre, Xi’an, China
| | - Ting Fu
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Xiaoang Qin
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Rui Li
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Mengwei Lu
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
- Department of Epidemiology, School of Public Health, Gansu University of Chinese Medicine, Lanzhou, China
| | - Yuhua Wang
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Wenkai Zhang
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Zhongjun Shao
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Yong Long
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
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Mattwich C, Huber K, Bretzel G, Suerbaum S, Wieser A, Dichtl K. Head-to-Head Comparison of Nine Assays for the Detection of Anti- Echinococcus Antibodies: A Retrospective Evaluation. Ann Lab Med 2024; 44:155-163. [PMID: 37880992 PMCID: PMC10628756 DOI: 10.3343/alm.2023.0212] [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: 05/19/2023] [Revised: 07/25/2023] [Accepted: 09/12/2023] [Indexed: 10/27/2023] Open
Abstract
Background Echinococcosis is a neglected tropical disease that is severely underdiagnosed in resource-limited settings. In developed countries, diagnosing echinococcosis is challenging, and reliable serological assays are urgently needed. In the Central European Alps, EM is more common than EG; however, data on the diagnostic performance of assays for EM cases are scarce. We evaluated the suitability of nine antibody assays for routine diagnostics. Methods Nine commercially available serological assays for detecting anti-Echinococcus antibodies were compared head-to-head using samples collected from 50 patients with echinococcosis and 50 age- and sex-matched control subjects. The assays are Anti-Echinococcus ELISA (IgG) (Euroimmun), Echinococcus IgG ELISA (DRG), Echinococcus IgG ELISA (IBL International), Echinococcus Western Blot IgG (LDBIO Diagnostics), EUROLINE WB (Euroimmun), Hydatidosis ELISA IgG (VirCell), Hydatidosis VIRCLIA IgG Monotest (VirCell), Ridascreen Echinococcus IgG (R-Biopharm), and Virapid Hydatidosis (VirCell). The cases were ranked according to the WHO-Informal Working Group on Echinococcosis (WHO-IWGE) criteria as confirmed, probable, or possible. Results The performance of the assays varied greatly, with overall sensitivities ranging between 50% and 88% and specificities between 62% and 100%. We observed a trend toward better performance with cases classified as "confirmed" using the WHO-IWGE criteria. Combined analysis with sequential screening and confirmatory testing resulted in a maximum sensitivity of 84% and specificity of 100%. Differentiation between EG and EM infections is clinically relevant but was found to be unreliable. Conclusions Echinococcus serological assays are highly variable in terms of sensitivity and specificity. Knowledge of the pre-test probability in the patient cohort is required to choose a suitable assay. A combined approach with screening and confirmatory assays may be the best diagnostic strategy in many situations.
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Affiliation(s)
- Carolina Mattwich
- Max von Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie, Medizinische Fakultät, LMU München, Munich, Germany
| | - Kristina Huber
- Division of Infectious Diseases and Tropical Medicine, University Hospital Ludwig-Maximilian University Munich, Munich, Germany
| | - Gisela Bretzel
- Division of Infectious Diseases and Tropical Medicine, University Hospital Ludwig-Maximilian University Munich, Munich, Germany
| | - Sebastian Suerbaum
- Max von Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie, Medizinische Fakultät, LMU München, Munich, Germany
| | - Andreas Wieser
- Max von Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie, Medizinische Fakultät, LMU München, Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, University Hospital Ludwig-Maximilian University Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
| | - Karl Dichtl
- Max von Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie, Medizinische Fakultät, LMU München, Munich, Germany
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
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Gu H, Hu Y, Guo S, Jin Y, Chen W, Huang C, Hu Z, Li F, Liu J. China's prevention and control experience of echinococcosis: A 19-year retrospective. J Helminthol 2024; 98:e16. [PMID: 38305033 DOI: 10.1017/s0022149x24000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Echinococcosis poses a significant threat to public health. The Chinese government has implemented prevention and control measures to mitigate the impact of the disease. By analyzing data from the Chinese Center for Disease Control and Prevention and the State Council of the People's Republic of China, we found that implementation of these measures has reduced the infection rate by nearly 50% between 2004 to 2022 (from 0.3975 to 0.1944 per 100,000 person-years). Nonetheless, some regions still bear a significant disease burden, and lack of detailed information limites further evaluation of the effects on both alveolar and cystic echinococcosis. Our analysis supports the continuing implementation of these measures and suggests that enhanced wildlife management, case-based strategies, and surveillance systems will facilitate disease control.
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Affiliation(s)
- H Gu
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - Y Hu
- Department of Biliary Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - S Guo
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - Y Jin
- Department of Biliary Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - W Chen
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - C Huang
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - Z Hu
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - F Li
- Department of Biliary Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - J Liu
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
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Weber TF, Mokry T, Stojkovic M. Echinococcoses - A Primer for Radiologists. ROFO-FORTSCHR RONTG 2023; 195:1106-1121. [PMID: 37467780 DOI: 10.1055/a-2114-1980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Cystic (CE) and alveolar (AE) echinococcoses are zoonotic parasitoses that may pose diagnostic problems due to their relative rarity in Middle Europe. METHODS Based on a recent literature search and the observation of casuistics from a national echinococcosis treatment center, epidemiological, radiological, and therapeutic fundamentals are presented and important differences between AE and CE are discussed. RESULTS AND CONCLUSION AE and CE must be regarded as completely different diseases, which differ from each other in every significant aspect. This applies not only to the epidemiological background of the patients but also to the biology of the diseases and their respective imaging features. KEY POINTS · AE and CE are very distinct from one another and must be considered separately.. · AE is endemic in Middle Europe and is known as malignant parasitosis due to its destructive growth form.. · CE is primarily seen in Middle Europe in individuals with migration background and has a rather benign character.. CITATION FORMAT · Weber TF, Mokry T, Stojkovic M. Die Echinokokkosen - Einblicke aus Sicht der Radiologie. Fortschr Röntgenstr 2023; 195: 1106 - 1121.
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Affiliation(s)
- Tim Frederik Weber
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
| | - Theresa Mokry
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
- Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Marija Stojkovic
- Tropical Medicine, Department of Infectiology, University Hospital Heidelberg, Germany
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Abbasi Dezfouli S, El Rafidi A, Aminizadeh E, Ramouz A, Al-Saeedi M, Khajeh E, Mieth M, Weber TF, Chang DH, Hoffmann K, Büchler MW, Mehrabi A. Risk factors and management of biliary leakage after Endocystectomy for hepatic cystic echinococcosis. PLoS Negl Trop Dis 2023; 17:e0011724. [PMID: 37906617 PMCID: PMC10637722 DOI: 10.1371/journal.pntd.0011724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/10/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Endocystectomy is a conservative surgical approach to managing cystic echinococcosis. Bile leakage is the main complication of this technique. The aim of this study was to evaluate the factors associated with bile leakage and to assess the outcomes and cost efficiency of strategies used to treat bile leakage. METHODOLOGY/PRINCIPAL FINDINGS Patients who underwent endocystectomy between 2005 and 2020 were included. The preoperative characteristics, intra- and postoperative outcomes, hospital costs, and cost efficiency (the Diagnosis-Related Group reimbursement minus the overall cost) were evaluated prospectively. A total of eighty patients with 142 cysts were included. Postoperative complications occurred in 17 patients (21%), including 11 patients with bile leakage (type A: 1, type B: 6 and type C: 4 patients, total 13%). Bile leakage was more frequent in patients with preoperative MRI signs of cysto-biliary fistulas or intraoperative visible cysto-biliary fistulas (p = 0.03 and p = 0.04, respectively) and in patients with cysts larger than 8 cm (p = 0.03). Patients with bile leakage who underwent reoperation (type C) had significantly shorter hospital stays (9 vs. 16 days, p<0.01) and better cost efficiency than those who received radiologic or endocscopic interventions (€2,072 vs. -€2,097 p = 0.01). No mortality was observed, and recurrence was seen in two patients. CONCLUSIONS/SIGNIFICANCE Endocystectomy is a safe and efficient technique. Preoperative and intraoperative cysto-biliary fistulas and a cyst diameter larger than 8 cm are correlated to postoperative bile leakage. Early operative management of bile leakage reduces hospital stay and improves cost efficiency compared with radiologic or endoscopic treatments.
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Affiliation(s)
- Sepehr Abbasi Dezfouli
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ahmad El Rafidi
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ehsan Aminizadeh
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ali Ramouz
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Mohammed Al-Saeedi
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Elias Khajeh
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Markus Mieth
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany
| | - Tim Frederik Weber
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - De-Hua Chang
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Kathrin Hoffmann
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany
| | - Markus W Büchler
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany
| | - Arianeb Mehrabi
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany
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10
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Berto CG, Liou P, Coyle CM, Emond JC. Surgical management of cystic echinococcosis of the liver. Curr Opin Infect Dis 2023; 36:348-352. [PMID: 37548389 DOI: 10.1097/qco.0000000000000955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PURPOSE OF REVIEW Cystic echinococcosis is a zoonotic infection frequently involving the liver. Treatment options, including surgery, are decided based on the staging of the disease. RECENT FINDINGS Ultrasound is the cornerstone for diagnosis, staging, and follow-up of cystic echinococcosis. MRI can help to evaluate for cystobiliary complications and planning of the surgery. The two main surgical approaches for cystic echinococcosis include a radical approach, which entails a partial hepatectomy and total pericystectomy, and a conservative approach or endocystectomy. Recent data suggest a conservative approach is well tolerated with acceptable morbidity and no mortality. Recurrences in centers with experience are rare. Data on laparoscopic surgery is emerging, but long-term follow-up still needs to be improved. SUMMARY Surgical treatment options should be carefully evaluated according to the cystic echinococcosis disease staging. A multidisciplinary approach, including diagnostic and interventional radiology, abdominal and liver surgery, and infectious diseases, results in better outcomes.
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Affiliation(s)
- Cesar G Berto
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Peter Liou
- Liver and Abdominal Transplant Surgery, Columbia University Irving Medical Center, New York
| | - Christina M Coyle
- Division of Infectious Disease, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Jean C Emond
- Liver and Abdominal Transplant Surgery, Columbia University Irving Medical Center, New York
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11
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Popova G, Vuchev D, Anichina K. Treatment of hepatic and pulmonary hydatidosis with albendazole and praziquantel. Helminthologia 2023; 60:221-226. [PMID: 38152469 PMCID: PMC10750241 DOI: 10.2478/helm-2023-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/27/2023] [Indexed: 12/29/2023] Open
Abstract
Conservative treatment of human hydatidosis (cystic echinococcosis) with albendazole has improved significantly the prognosis of the disease. But its therapeutic effectiveness is 30 - 70 %. There is some evidence that the effectiveness of albendazole can be enhanced by praziquantel but there is no strict recommendation for the use of praziquantel as part of long-term drug therapy for hydatidosis. The aim of the study was to evaluate the effectiveness of the combination of albendazole and praziquantel in patients with hepatic and/or pulmonary hydatidosis. A total of 20 patients (aged 12 - 70 years old) were included in the study for a 5-year period. Fourteen patients (70 %) were with hepatic hydatidosis, 4 (20 %) with pulmonary and 2 (10 %) with hepatic and pulmonary hydatidosis. They were treated with albendazole (15 mg/kg/day) and praziquantel (40 mg/kg/weekly) for 2 - 9 one-month courses. The result of the therapy was followed using imaging (abdominal ultrasound, lung radiography, computed tomography) and serology. Seventeen (85 %) out of 20 patients showed evidence of response on imaging defined as improvement or cure of hydatid cysts. Seven (35 %) of the patients with multiple cystic echinococcosis took praziquantel once a week for 6 months. Only 3 patients (15 %) with multiple hydatidosis (2 with liver and 1 with pulmonary hydatidosis) failed to respond to the therapy with both drugs. No side effects have been reported by the patients. The combination of albendazole and praziquantel seems to be an option to improve the therapeutic effectiveness of the conservative treatment of cystic echinococcosis.
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Affiliation(s)
- G. Popova
- Medical University of Plovdiv, Department of Infectious diseases, Parasitology and Tropical Medicine, Section of Parasitology, St. George University Hospital, Plovdiv, Bulgaria
| | - D. Vuchev
- Medical University of Plovdiv, Department of Infectious diseases, Parasitology and Tropical Medicine, Section of Parasitology, St. George University Hospital, Plovdiv, Bulgaria
| | - K. Anichina
- University of Chemical Technology and Metallurgy, Sofia, Bulgaria
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12
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Popa GL, Popa AC, Mastalier B, Crețu CM, Popa MI. Complicated Clinical Course of a Patient with Multivisceral Cystic Echinococcosis Requiring Extensive Surgical and Medical Treatment. J Clin Med 2023; 12:5596. [PMID: 37685663 PMCID: PMC10488279 DOI: 10.3390/jcm12175596] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Cystic echinococcosis is an often-overlooked condition that otherwise negatively impacts both the individual and the community, prompting major public health concerns. Early diagnosis and treatment, as well as collaboration between specialties including surgery and parasitology, are essential for avoiding complications and disease relapse. To better illustrate this, we present the case of an elderly person with a rare localization of the disease at the muscular level. The patient underwent numerous surgical interventions, and received multiple courses of antiparasitic treatment over the course of 40 years as a result of the multivisceral dissemination of the parasite.
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Affiliation(s)
- Gabriela Loredana Popa
- Department of Microbiology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Parasitic Disease Department, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Alexandru Cosmin Popa
- Departament of Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.C.P.); (B.M.)
- Surgery Department, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Bogdan Mastalier
- Departament of Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.C.P.); (B.M.)
- Surgery Department, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Carmen Michaela Crețu
- Parasitic Disease Department, Colentina Clinical Hospital, 020125 Bucharest, Romania;
- Department of Parasitology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mircea Ioan Popa
- Department of Microbiology II, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Cantacuzino National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
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13
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Qin M, Wang L, Wang Y, Wang X, Lei J, Cheng X, Feng Y, Hou Y, Wang Q, Xue C, Gavotte L, Frutos R. Investigation on the Management for Patients with Echinococcosis Treated with Albendazole - Three PLADs, China, 2019. China CDC Wkly 2023; 5:437-441. [PMID: 37274767 PMCID: PMC10236642 DOI: 10.46234/ccdcw2023.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/18/2023] [Indexed: 06/06/2023] Open
Abstract
What is already known about this topic? In China, patients with echinococcosis receive complimentary healthcare services, such as medical treatment, diagnostic examinations, and follow-up care. Despite this, no studies have been conducted to assess the quality of patient management to date. What is added by this report? This study reviewed the medical records of 899 patients who underwent albendazole treatment across 10 endemic counties. Out of 634 evaluable patient files, the proportion of patients with a ratio of actual follow-up and reexamination times to theoretical follow-up and reexamination times ≥0.8 were both low (21.92% and 23.19%, respectively). What are the implications for public health practices? This study identified weaknesses and specific issues in patient management and proposed feasible recommendations to enhance patient file documentation, follow-up, and reexamination.
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Affiliation(s)
- Min Qin
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Liying Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
- Espace-Dev, UMR 228, Université de Montpellier, Montpellier, France
- Cirad, UMR 17, Intertryp, Campus international de Baillarguet, Montpellier, France
| | - Ying Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Xu Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Jiaxi Lei
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Xixi Cheng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Yu Feng
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou City, Gansu Province, China
| | - Yanyan Hou
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi City, Xinjiang Uygur Autonomous Region, China
| | - Qian Wang
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu City, Sichuan Province, China
| | - Chuizhao Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Laurent Gavotte
- Espace-Dev, UMR 228, Université de Montpellier, Montpellier, France
| | - Roger Frutos
- Cirad, UMR 17, Intertryp, Campus international de Baillarguet, Montpellier, France
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Huang L, Zheng B, Li X, Yao J. Association between radical versus conservative surgery and short-term outcomes of hepatic cystic echinococcosis in Nyingchi, China: a retrospective cohort study. BMC Surg 2023; 23:126. [PMID: 37173700 PMCID: PMC10182614 DOI: 10.1186/s12893-023-02000-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 04/10/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Radical or conservative surgical treatment for hepatic Cystic Echinococcosis (hepatic CE) is controversial. We aimed to measure the association between radical surgery (RS) versus conservative surgery (CS) and short-term outcomes in our cohort. METHODS Medical records of hepatic CE patients' demographic, clinical, radiological, operative and postoperative details who underwent surgical treatment between January 3, 2017 and January 3, 2018 at the Department of General Surgery, Nyingchi People's Hospital, Nyingchi, China, were retrieved and analyzed. The primary outcome was overall morbidity. The secondary outcomes included: (i) bile leakage; (ii) complications of lung, pleura, heart, liver, pancreas and biliary tract; (iii) incision infection and residual cavity abscess formation; (iv) anaphylactic reaction and shock; (v) tear of surrounding tissues; (vi) hospital and post-operative length of stay (LOS); (vii) length of surgery; (viii) blood loss during surgery. Multivariable logistic/linear regression models with various adjustment strategies for confounders were performed to evaluate the association. RESULTS A total of 128 hepatic CE patients were included with 82 (64.1%) and 46 (35.9%) receiving CS and RS, respectively. After fully adjusted, RS was associated with 60% lower risk of overall complication (aOR 0.4; 95%CI, 0.2-0.9) and 0.6-h shorter surgical time (aβ 0.4; 95%CI,-0.0-0.8) comparing to CS. However, RS was associated with more blood loss during surgery (aβ 179.3; 95%CI, 54.2-304.5). CONCLUSION To conclude, RS was associated with a 60% reduction in developing overall complication in the short term, but may result in more blood loss during surgery than CS.
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Affiliation(s)
- Liangping Huang
- Department of Drug and Medical Device Clinical Trial Office, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Hematology and Oncology, Shenzhen Children's Hospital of China Medical University, Shenzhen, China
| | - Benrong Zheng
- Physical Examination Center, Nyingchi People's Hospital, Nyingchi, China
- Department of VIP Health Care Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xi Li
- Department of General Surgery, Nyingchi People's Hospital, Nyingchi, China.
- Department of Thyroid and Breast Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No.600 Tianhe Road, Guangzhou, 510630, China.
| | - Jianchun Yao
- Department of Anesthesiology, Nyingchi People's Hospital, Nyingchi, China.
- Department of Anesthesiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Jinping District, Shantou, 515041, Guangdong Province, China.
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15
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Hager J, Sergi CM. Pediatric Echinococcosis of the Liver in Austria: Clinical and Therapeutical Considerations. Diagnostics (Basel) 2023; 13:diagnostics13071343. [PMID: 37046561 PMCID: PMC10093495 DOI: 10.3390/diagnostics13071343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/08/2023] Open
Abstract
Echinococcosis is considered a neglected disease in most European countries. However, migratory flows of populations, long-term stays in endemic areas, uninterrupted tourism (travel to Echinococcus-endemic countries), traveling dogs and dog translocations from endemic areas, and inappropriate hygiene practices are potential factors that alarm public health officials. Identifying a cyst-like mass in the liver or lung of an individual with a travel history of likely exposure to sheepdogs in an area where the parasite Echinococcus (E.) granulosus (sive cysticus) is endemic advocates for a prompt preliminary diagnosis of cystic echinococcosis (CE), no matter the age of the affected individuals. Routine imaging techniques, including ultrasonography, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans, are used to detect cysts. After a cyst has been discovered, serologic investigations are used to confirm the diagnosis. Typically, alveolar echinococcosis (AE) is found in older individuals. Yet young people are also affected because frequent oral exploration of the environment is a regular behavior for infants and toddlers. In this review, therapeutic considerations for pediatric echinococcosis—drug-based benzimidazole therapy; AE: atypical liver resection, the resection of individual or multiple segments, a right or left hemi-hepatectomy, or an extended hemi-hepatectomy; CE: PAIR-technique, cyst excision, liver segment(s) resection (laparoscopically or conventionally)—are revised following experience in one of the most affected regions of Europe. In addition, we performed a systematic review using three databases (i.e., PubMed, EMBASE, and Scopus) to evaluate the quality of evidence in published studies on pediatric echinococcosis.
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Affiliation(s)
- Josef Hager
- Pediatric Surgery, University Clinic of Surgery, Medical University, 6020 Innsbruck, Austria
| | - Consolato M. Sergi
- Anatomic Pathology Division, Children’s Hospital of Eastern Ontario (CHEO), University of Ottawa, Ottawa, ON K1H 8L1, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, 8440 112 St, Edmonton, AB T6G 2B7, Canada
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16
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Denzinger M, Nasir N, Steinkraus K, Michalski C, Hüttner FJ, Traub B. [Treatment concepts for hepatic echinococcosis]. CHIRURGIE (HEIDELBERG, GERMANY) 2023; 94:560-570. [PMID: 36853342 DOI: 10.1007/s00104-023-01825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The incidence of both cystic (CE) and alveolar echinococcosis (AE) is increasing in Germany. The CE can often be managed with drug treatment and interventional strategies. In contrast, AE shows characteristics of a malignant disease with a high morbidity and mortality. Benzimidazoles are potent drugs for both entities but with the necessity for a lifelong follow-up and the risk of side effects as well as progression under treatment. Therefore, the indications for surgical resection have to be carefully considered; however, the combination of drug treatment and surgery is the only curative approach. Recently, the use of minimally invasive surgery with reduced morbidity and mortality has justified surgical resection for a broader set of patients; however, minimally invasive surgery requires a high level of expertise and optimal perioperative planning. Therefore, treatment strategies, especially for AE require an individual stratified risk-benefit assessment in an interdisciplinary consensus.
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Affiliation(s)
- Maximilian Denzinger
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland.
| | - Nadir Nasir
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Kira Steinkraus
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Christoph Michalski
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Felix J Hüttner
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Benno Traub
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
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17
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Jaén-Torrejimeno I, Ramia JM, López-Guerra D, Rojas-Holguín A, De-Armas-Conde N, Blanco-Fernández G. Textbook outcome in the surgical treatment of liver hydatid cyst. Surgery 2023; 173:429-434. [PMID: 36334979 DOI: 10.1016/j.surg.2022.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Textbook outcome is a composite measure used in surgery to define the ideal postoperative period and to assess the quality of care. The aim of this study was to analyze the incidence of textbook outcome and the factors independently associated with its achievement following surgical treatment of liver hydatid cysts. METHODS Retrospective cohort study of patients operated on for liver hydatid cysts between January 2006 and December 2021. Textbook outcome was achieved when all the following criteria were fulfilled: no mortality within 90 days, no major complications within 90 days, no hospital readmission within 90 days, and no prolonged hospital stay. Univariable and multivariable analyses were performed to identify factors associated with textbook outcome. RESULTS During the study period, 296 patients underwent surgery. Textbook outcome was recorded in 65.9% (195/296). Female gender (odds ratio 2.02; P = .010), noncomplicated cyst (odds ratio 3.97, P < .001), and radical surgery (odds ratio 2.26, P = .003) were the variables associated with a higher probability of achieving textbook outcome. CONCLUSION Textbook outcome may be a useful measure to assess the variations in surgical management between different centers, and to improve quality of care after liver hydatid cysts resection.
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Affiliation(s)
| | - José M Ramia
- Department of Surgery, Hospital Universitario de Alicante, Spain
| | - Diego López-Guerra
- Department of HBP and Liver Transplant Surgery, Hospital Universitario de Badajoz, Spain; Universidad de Extremadura, Facultad de Medicina y Ciencias de la Salud
| | - Adela Rojas-Holguín
- Department of HBP and Liver Transplant Surgery, Hospital Universitario de Badajoz, Spain; Universidad de Extremadura, Facultad de Medicina y Ciencias de la Salud
| | - Noelia De-Armas-Conde
- Department of HBP and Liver Transplant Surgery, Hospital Universitario de Badajoz, Spain
| | - Gerardo Blanco-Fernández
- Universidad de Extremadura, Facultad de Medicina y Ciencias de la Salud; Department of HBP and Liver Transplant Surgery, Hospital Universitario de Badajoz, Spain.
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Hadipour M, Fasihi Harandi M, Mirhendi H, Yousofi Darani H. Diagnosis of echinococcosis by detecting circulating cell-free DNA and miRNA. Expert Rev Mol Diagn 2023; 23:133-142. [PMID: 36756744 DOI: 10.1080/14737159.2023.2178903] [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: 02/10/2023]
Abstract
INTRODUCTION Diagnosis of echinococcosis is difficult and usually performed based on clinical findings, imaging, and serological test. However, all of them have limitations, especially in follow-up approaches. AREAS COVERED Detection of cell-free DNA (cfDNA) and micro-RNA (miRNA) is currently a hot topic for diagnosis of echinococcosis diseases. For detecting cell-free DNA in echinococcosis patient's samples such as sera, some techniques are based on next-generation sequencing (NGS), DNA-deep sequencing, some are based on PCR-based methods, and a few works related to the detection of miRNA for the diagnosis of human echinococcosis. EXPERT OPINION In the detection of cell-free DNA in echinococcosis patient' samples, NGS and DNA-deep sequencing have shown high level of sensitivity, but are not suitable for routine clinical examination as they are expensive and inaccessible in the majority of endemic areas. However, PCR-based methods have shown a sensitivity of about 20-25%. To improve the sensitivity of these tests, improving the DNA extraction method, designing appropriate primers for detecting short-length fragments of circulating DNA, using a higher volume of a serum sample, and application of more sensitive PCR methods are recommended. In the field of miRNA detection, further works are recommended.
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Affiliation(s)
- Mahboubeh Hadipour
- Department of parasitology and mycology, Faculty of medicine, Isfahan University of Medical sciences, Isfahan, Iran
| | - Majid Fasihi Harandi
- Research center for Hydatid disease in Iran, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Mirhendi
- Department of parasitology and mycology, Faculty of medicine, Isfahan University of Medical sciences, Isfahan, Iran
| | - Hossein Yousofi Darani
- Department of parasitology and mycology, Faculty of medicine, Isfahan University of Medical sciences, Isfahan, Iran
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19
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Govindasamy A, Bhattarai PR, John J. Liver cystic echinococcosis: a parasitic review. Ther Adv Infect Dis 2023; 10:20499361231171478. [PMID: 37197609 PMCID: PMC10184195 DOI: 10.1177/20499361231171478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/05/2023] [Indexed: 05/19/2023] Open
Abstract
Liver cystic echinococcosis (CE), known as hydatid disease, is caused by the tapeworm Echinococcus granulosus sensu lato. Humans are accidental hosts in this zoonotic disease process, and hepatic infection accounts for over two-thirds of all cases. Since signs and symptoms are mainly non-specific, especially in early disease, clinicians should have a low threshold to include CE as a differential diagnosis in patients with positive serology and suggestive radiological findings, especially in endemic regions. The standard management for liver CE depends on the patient's symptoms, the radiological stage, the size and location of the cyst, the presence of complications and the treating clinicians' expertise. In this review, we discuss the lifecycle of Echinococcus granulosus sensu lato and its epidemiology and then focus on discussing the clinical features, diagnosis and treatment options of CE of the liver.
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Affiliation(s)
| | - Pushpa Raj Bhattarai
- Division of General Surgery, Department of Surgery, Frere Hospital and Walter Sisulu University, East London, South Africa
| | - Jeff John
- Division of Urology, Department of Surgery, Frere Hospital and Walter Sisulu University, East London, South Africa
- Division of Urology, Department of Surgery, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
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20
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Ferra Murcia S, Cabezas Fernández MT, Fernández Fuertes E, Collado Romacho AR. Dorsolumbalgia y colecciones paravertebrales con afectación ósea de etiología inesperada. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Ferra Murcia S, Cabezas Fernández MT, Fernández Fuertes E, Collado Romacho AR. Back pain and paravertebral collections with bone involvement of unexpected etiology. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:396-398. [PMID: 35537996 DOI: 10.1016/j.eimce.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Sergio Ferra Murcia
- Unidad de Enfermedades Infecciosas, Servicio Medicina Interna, Hospital Universitario Torrecárdenas, Almería, Spain.
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22
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Yaqub S, Jensenius M, Heieren OE, Drolsum A, Pettersen FO, Labori KJ. Echinococcosis in a non-endemic country - 20-years' surgical experience from a Norwegian tertiary referral Centre. Scand J Gastroenterol 2022; 57:953-957. [PMID: 35246008 DOI: 10.1080/00365521.2022.2046846] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND In Scandinavia, the incidence of cystic echinococcosis (CE) and alveolar echinococcosis (AE) is low and almost exclusively an imported disease following the trends of immigration. The aim of the study was to review available data on clinical management and outcome for patients treated at Oslo University Hospital, a referral centre for echinococcosis in Norway, with special emphasis on surgical treatment. METHODS All patients admitted with echinococcosis between January 2000 and December 2020 were identified. Medical records were reviewed retrospectively concerning patient demographics, treatment strategy, surgical procedures, complications and outcomes. RESULTS A total of 92 patients with median age 37 years (range 4-85) were identified. Sixty-eight patients (74%) were symptomatic. All patients, except for two, were immigrants to Norway and born in endemic areas. Ninety patients were diagnosed with CE and two with AE. Location of the cysts was most commonly in the liver (86%) followed by peritoneum, lungs, and spleen. All patients with active cysts were treated with albendazole. Surgical treatment was performed in 51 (56%) patients. The most common reason for abstaining from surgical treatment was that the diagnostic work-up revealed inactive cysts or interventional radiology was performed. Of the 51 patients who underwent surgery, a radical procedure was performed in 32 (64%) cases, a conservative procedure in 12 (24%), and a combination in six (12%). Clavien Dindo grade ≥3 complications occurred in 30%, and 90-day mortality was 2%. Bile leakage occurred in seven patients and was treated successfully with endoscopic retrograde cholangiopancreatography with biliary stent placement in all patients. CONCLUSION In a low-endemic area like Norway, management of echinococcus includes medical therapy, surgery, and/or interventional radiology. Surgical intervention seems to be effective, and is associated with acceptable morbidity rates.
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Affiliation(s)
- Sheraz Yaqub
- Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mogens Jensenius
- Department of Infectious Diseases - Ullevål, Oslo University Hospital, Oslo, Norway
| | | | - Anders Drolsum
- Department of Radiology, Oslo University Hospital, Oslo, Norway
| | - Frank O Pettersen
- Regional Advisory Unit for Imported and Tropical Diseases, Dept. of Infectious Diseases - Ullevål, Oslo University Hospital, Oslo, Norway
| | - Knut Jørgen Labori
- Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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23
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Expression profiling of exosomal miRNAs derived from different stages of infection in mice infected with Echinococcus granulosus protoscoleces using high-throughput sequencing. Parasitol Res 2022; 121:1993-2008. [PMID: 35511364 DOI: 10.1007/s00436-022-07536-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
Abstract
Echinococcosis is a worldwide zoonosis. The mechanism of the establishment, growth, and persistence of parasites in the host has not been fully understood. Exosomes are found to be a way of information exchange between parasites and hosts. They exist in various body fluids widely. There are few studies on host-derived exosomes and their miRNA expression profiles at different infection time points. In this study, BALB/c mice were intraperitoneally infected with protricercariae. Exosomes were extracted from plasma (0, 3, 9, and 20 weeks post infection), and the expression profiles of exosome miRNA in the peripheral blood of mice were determined using RNA-sequencing. Compared to the 0 week groups, 24, 35, and 22 differentially expressed miRNAs were detected in infected mouse at the three infection stages, respectively. The results showed that there were significant differences in the miRNAs of exosomes at different infection time points. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were used to annotate the different miRNAs. The results showed that the biological pathways of parasites changed significantly at different stages of infection, with many significant and abundant pathways involved in cell differentiation, inflammation, and immune response, such as MAPK signaling pathway, Th17 cell differentiation, Wnt signaling pathway, FoxO signaling pathway, Notch signaling pathway, etc. These results suggest that miRNA may be an important regulator of interactions between Echinococcus granulosus and host. The data provided here provide valuable information to increase understanding of the regulatory function of microRNAs in the host microenvironment and the mechanism of host-parasite interaction. This may help us to find targets for Echinococcus granulosus to escape host immune attack and control Echinococcus granulosus infection in the future.
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24
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Lv Y, Zhu Y, Chang L, Yang J, Zhao Y, Zhao J, Wang Y, Zhu M, Wu C, Zhao W. Identification of a dominant murine T-cell epitope in recombinant protein P29 from Echinococcus granulosus. Acta Biochim Biophys Sin (Shanghai) 2022; 54:482-493. [PMID: 35607954 PMCID: PMC9827856 DOI: 10.3724/abbs.2022036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 11/11/2021] [Indexed: 11/25/2022] Open
Abstract
Echinococcus granulosus causes echinococcosis, an important zoonotic disease worldwide and a major public health issue. Vaccination is an economical and practical approach for controlling E. granulosus. We have previously revealed that a recombinant protein P29 (rEg.P29) is a good vaccine candidate against E. granulosus. However, T cell immunogenic epitopes have not been identified. In the present study, we use rEg.P29-immunized mice as models to screen immunogenic epitopes for the construction of a novel multi-epitope vaccine. We search for immunodominant epitopes from an overlapping peptide library to screen the peptides of rEg.P29. Our results confirm that rEg.P29 immunization in mice elicits the activation of T cells and induces cellular immune responses. Further analyses show that a T cell epitope within amino acids 86–100 of rEg.P29 elicits significant antigen-specific IFN-γ production in CD4+ and CD8+ T cells and promotes specific T-cell activation and proliferation. Collectively, these results provide a reference for the construction of a novel vaccine against broad E. granulosus genotypes based on epitopes of rEg.P29.
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Affiliation(s)
- Yongxue Lv
- School of Basic MedicineNingxia Medical UniversityYinchuan750004China
- Department of Pathogen Biology and Medical ImmunologyNingxia Medical UniversityYinchuan750004China
| | - Yazhou Zhu
- School of Basic MedicineNingxia Medical UniversityYinchuan750004China
| | - Liangliang Chang
- School of Basic MedicineNingxia Medical UniversityYinchuan750004China
| | - Jihui Yang
- School of Basic MedicineNingxia Medical UniversityYinchuan750004China
- Department of Pathogen Biology and Medical ImmunologyNingxia Medical UniversityYinchuan750004China
| | - Yinqi Zhao
- School of Basic MedicineNingxia Medical UniversityYinchuan750004China
| | - Jiaqing Zhao
- School of Basic MedicineNingxia Medical UniversityYinchuan750004China
- Department of Pathogen Biology and Medical ImmunologyNingxia Medical UniversityYinchuan750004China
| | - Yana Wang
- School of Basic MedicineNingxia Medical UniversityYinchuan750004China
| | - Mingxing Zhu
- School of Basic MedicineNingxia Medical UniversityYinchuan750004China
| | - Changyou Wu
- Institute of ImmunologyZhongshan School of MedicineSun Yat-sen University Guangzhou 5102275China
| | - Wei Zhao
- School of Basic MedicineNingxia Medical UniversityYinchuan750004China
- Department of Pathogen Biology and Medical ImmunologyNingxia Medical UniversityYinchuan750004China
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25
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Yang S, Du X, Wang C, Zhang T, Xu S, Zhu Y, Lv Y, Zhao Y, Zhu M, Guo L, Zhao W. Coding and Noncoding RNA Expression Profiles of Spleen CD4 + T Lymphocytes in Mice with Echinococcosis. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:9742461. [PMID: 35480082 PMCID: PMC9012641 DOI: 10.1155/2022/9742461] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022]
Abstract
Cystic echinococcosis (CE) is a severe and neglected zoonotic disease that poses health and socioeconomic hazards. So far, the prevention and treatment of CE are far from meeting people's ideal expectations. Therefore, to gain insight into the prevention and diagnosis of CE, we explored the changes in RNA molecules and the biological processes and pathways involved in these RNA molecules as E. granulosus infects the host. Interferon (IFN)-γ, interleukin (IL)-2, IL-4, IL-6, IL-10, IL-17A, and tumor necrosis factor (TNF)-α levels in peripheral blood serum of E. granulosus infected and uninfected female BALB/c mice were measured using the cytometric bead array mouse Th1/Th2/Th17 cytokine kit. mRNA, microRNA (miRNA), long noncoding RNA (lncRNA), and circular RNA (circRNA) profiles of spleen CD4+ T cells from the two groups of mice were analyzed using high-throughput sequencing and bioinformatics. The levels of IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-17A, and TNF-α were significantly higher in the serum of the CE mice than in control mice (P < 0.01). In total, 1,758 known mRNAs, 37 miRNAs, 175 lncRNAs, and 22 circRNAs were differentially expressed between infected and uninfected mice (|fold change| ≥ 0.585, P < 0.05). These differentially expressed molecules are involved in chromosome composition, DNA/RNA metabolism, and gene expression in cell composition, biological function, and cell function. Moreover, closely related to the JAK/STAT signaling pathways, mitogen-activated protein kinase signaling pathways, P53 signaling pathways, PI3K/AKT signaling pathways, cell cycle, and metabolic pathways. E. granulosus infection significantly increased the levels of IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-17A, and TNF-α in mouse peripheral blood of mice and significantly changed expression levels of various coding and noncoding RNAs. Further study of these trends and pathways may help clarify the pathogenesis of CE and provide new insights into the prevention and treatment of this disease.
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Affiliation(s)
- Songhao Yang
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Department of Medical Genetics and Cell Biology, School of Basic Medical Science of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
| | - Xiancai Du
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Department of Medical Genetics and Cell Biology, School of Basic Medical Science of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
| | - Chan Wang
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Department of Medical Genetics and Cell Biology, School of Basic Medical Science of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
| | - Tingrui Zhang
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Department of Medical Genetics and Cell Biology, School of Basic Medical Science of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
| | - Shimei Xu
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Center of Scientific Technology of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
| | - Yazhou Zhu
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Department of Medical Genetics and Cell Biology, School of Basic Medical Science of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
| | - Yongxue Lv
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Department of Medical Genetics and Cell Biology, School of Basic Medical Science of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
| | - Yinqi Zhao
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Center of Scientific Technology of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
| | - Mingxing Zhu
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Department of Medical Genetics and Cell Biology, School of Basic Medical Science of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Center of Scientific Technology of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
| | - Lingna Guo
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Center of Scientific Technology of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
| | - Wei Zhao
- Key Laboratory of Prevention and Control of Common Infectious Diseases of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region 750004, Yinchuan, China
- Department of Medical Genetics and Cell Biology, School of Basic Medical Science of Ningxia Medical University, Ningxia Hui Autonomous Region 750004, Yinchuan, China
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26
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Calame P, Weck M, Busse-Cote A, Brumpt E, Richou C, Turco C, Doussot A, Bresson-Hadni S, Delabrousse E. Role of the radiologist in the diagnosis and management of the two forms of hepatic echinococcosis. Insights Imaging 2022; 13:68. [PMID: 35394226 PMCID: PMC8994011 DOI: 10.1186/s13244-022-01190-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
Echinococcosis is a parasitic disease caused by two zoonotic tapeworms (cestodes) of the Echinocococcus genus. It can be classified as either alveolar or cystic echinococcosis. Although the two forms differ significantly in terms of imaging findings, they share similarities in terms of management and treatment. In parallel to medical treatment with albendazole (ABZ), and surgery, historically used in these diseases, various imaging-guided interventional procedures have recently emerged (drainage, stenting, or Puncture, aspiration, injection, and reaspiration (PAIR)). These options open up a new range of therapeutic options. As in oncology, multidisciplinary consultation meetings now play a major role in adapted management and patient care in hepatic echinococcosis. Consequently, diagnostic imaging and interventional expertise have brought radiologists to the fore as important members of these multidisciplinary team. The radiologist will need to evaluate parasite activity in both forms of the disease, to guide the choice of the appropriate therapy from among medical treatment, interventional radiology procedures and/or surgical treatment. Knowledge of the specific complications of the two forms of echinococcosis will also help radiologists to discuss the appropriate treatment and management. The aim of this review is to describe the core knowledge that what a radiologist should possess to actively participate in multidisciplinary meetings about hepatic echinococcosis. We discuss the role of imaging, from diagnosis to treatment, in alveolar (AE) and cystic echinococcosis (CE), respectively.
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Affiliation(s)
- Paul Calame
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France. .,EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Bourgogne Franche-Comté, Besançon, France.
| | - Mathieu Weck
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Andreas Busse-Cote
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Eleonore Brumpt
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Carine Richou
- Department of Hepatology, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Celia Turco
- Department of Digestive Surgery, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Alexandre Doussot
- Department of Digestive Surgery, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Solange Bresson-Hadni
- Laboratoire de Parasitologie-Mycologie, University Hospital Besançon, 25030, Besançon, France.,Centre National de Référence Echinococcoses, University Hospital Besançon, 25030, Besançon, France
| | - Eric Delabrousse
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France.,EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Bourgogne Franche-Comté, Besançon, France
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27
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Du X, Zhu M, Zhang T, Wang C, Tao J, Yang S, Zhu Y, Zhao W. The Recombinant Eg.P29-Mediated miR-126a-5p Promotes the Differentiation of Mouse Naive CD4 + T Cells via DLK1-Mediated Notch1 Signal Pathway. Front Immunol 2022; 13:773276. [PMID: 35211114 PMCID: PMC8861942 DOI: 10.3389/fimmu.2022.773276] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/18/2022] [Indexed: 12/12/2022] Open
Abstract
Cystic echinococcosis (CE) is a zoonotic parasitic disease spread worldwide caused by Echinococcus granulosus (Eg), which sometimes causes serious damage; however, in many cases, people are not aware that they are infected. A number of recombinant vaccines based on Eg are used to evaluate their effectiveness against the infection. Our previous report showed that recombinant Eg.P29 (rEg.P29) has a marvelous immunoprotection and can induce Th1 immune response. Furthermore, data of miRNA microarray in mice spleen CD4+ T cells showed that miR-126a-5p was significantly elevated 1 week after immunization by using rEg.P29. Therefore, in this perspective, we discussed the role of miR-126a-5p in the differentiation of naive CD4+ T cells into Th1/Th2 under rEg.P29 immunization and determined the mechanisms associated with delta-like 1 homolog (DLK1) and Notch1 signaling pathway. One week after P29 immunization of mice, we found that miR-126a-5p was significantly increased and DLK1 expression was decreased, while Notch1 pathway activation was enhanced and Th1 response was significantly stronger. The identical conclusion was obtained by overexpression of mmu-miR-126a-5p in primary naive CD4+ T cells in mice. Intriguingly, mmu-miR-126a-5p was significantly raised in serum from mice infected with protoscolex in the early stages of infection and markedly declined in the late stages of infection, while has-miR-126-5p expression was dramatically reduced in serum from CE patients. Taken together, we show that miR-126a-5p functions as a positive regulator of Notch1-mediated differentiation of CD4+ T cells into Th1 through downregulating DLK1 in vivo and in vitro. Hsa-miR-126-5p is potentially a very promising diagnostic biomarker for CE.
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Affiliation(s)
- Xiancai Du
- School of Basic Medical Science of Ningxia Medical University, Yinchuan, China.,Ningxia Key Laboratory of Prevention and Control of Common Infectious Diseases, Yinchuan, China
| | - Mingxing Zhu
- Ningxia Key Laboratory of Prevention and Control of Common Infectious Diseases, Yinchuan, China.,Center of Scientific Technology of Ningxia Medical University, Yinchuan, China
| | - Tingrui Zhang
- School of Basic Medical Science of Ningxia Medical University, Yinchuan, China.,Ningxia Key Laboratory of Prevention and Control of Common Infectious Diseases, Yinchuan, China
| | - Chan Wang
- School of Basic Medical Science of Ningxia Medical University, Yinchuan, China.,Ningxia Key Laboratory of Prevention and Control of Common Infectious Diseases, Yinchuan, China
| | - Jia Tao
- School of Basic Medical Science of Ningxia Medical University, Yinchuan, China.,Ningxia Key Laboratory of Prevention and Control of Common Infectious Diseases, Yinchuan, China
| | - Songhao Yang
- School of Basic Medical Science of Ningxia Medical University, Yinchuan, China.,Ningxia Key Laboratory of Prevention and Control of Common Infectious Diseases, Yinchuan, China
| | - Yazhou Zhu
- School of Basic Medical Science of Ningxia Medical University, Yinchuan, China.,Ningxia Key Laboratory of Prevention and Control of Common Infectious Diseases, Yinchuan, China
| | - Wei Zhao
- Ningxia Key Laboratory of Prevention and Control of Common Infectious Diseases, Yinchuan, China.,Center of Scientific Technology of Ningxia Medical University, Yinchuan, China
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28
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Shakib P, Sheikhian A, Moradpour K, Kalani H, Pour MZ, Cheraghipour K, Beiranvand M. In vivo and in vitro anti-hydatidosis effect of garlic: a systematic review. CURRENT DRUG THERAPY 2022. [DOI: 10.2174/1574885517666220207144802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Hydatidosis is a parasitic disease caused by the larval stage of Echinococcus granulosus sensu lato. The aim of the current systematic review study was to clarify the effect of garlic on hydatid cyst in vivo and in vitro.
Method:
We performed our analyses up to Feb 20, 2021, in accordance with the PRISMA guideline. We systematically searched five English databases (Science Direct, PubMed, Scopus, Ovid and Cochrane) and four Persian databases (Scientific Information Database [SID], Iran Medex, Iran Doc, and Magiran) with appropriate syntax. The data was extracted from the relevant articles and analyzed.
Results:
From 160 studies obtained by initial search, nine studies were selected for further analysis. Among 6 in vitro study, 3 (50%) used methanolic extract, 2 (34%) hydroalcoholic and chloroformic extract, and 1 (16%) chloroformic extract. Two (67%) studies used BALB/c mice, and one study (33%) used Swiss albino mice. The method of treatment of mice in all studies was oral. The results showed that garlic has mild to potent effect on hydatidosis and this effect was more considerable in vitro than in vivo.
Conclusion:
Based on the results of various studies, it can be concluded that Allium sativum extract can be used as a suitable alternative to drugs such as Albendazole or can be used as complementary treatment to reduce the dose of the current drugs.
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Affiliation(s)
- Pegah Shakib
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ali Sheikhian
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Kobra Moradpour
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hamed Kalani
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Kourosh Cheraghipour
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Marjan Beiranvand
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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29
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Blatz AM, Laycock KM, Kaur I, Swami SK. Acute Respiratory Failure With Hemoptysis in a Teenager Due to Cystic Echinococcosis. J Pediatric Infect Dis Soc 2022; 11:33-35. [PMID: 34553757 DOI: 10.1093/jpids/piab086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 09/03/2021] [Indexed: 11/14/2022]
Abstract
A previously healthy 14-year-old male presented with abrupt onset respiratory failure with hemoptysis and anaphylaxis. Imaging demonstrated a large, cystic lesion with bronchopleural fistula that was consistent with cystic echinococcosis. He underwent thoracotomy for cyst removal and bronchopleural fistula repair, then completed 3 months of albendazole therapy. He developed recurrence of a bronchopleural fistula 4 months after surgery which improved over time with conservative management. This case highlights pathognomonic imaging and pathology findings for cystic echinococcosis.
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Affiliation(s)
- Allison M Blatz
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Katherine M Laycock
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Ishminder Kaur
- Department of Pediatrics, Division of Infectious Diseases, UCLA Mattel Children's Hospital, Los Angeles, California, USA
| | - Sanjeev K Swami
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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30
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Ben Salah E, Barrera C, Sakly W, Mosbahi S, Balliau T, Franche N, Gottstein B, Ben Youssef S, Mekki M, Babba H, Millon L. Novel biomarkers for the early prediction of pediatric cystic echinococcosis post-surgical outcomes. J Infect 2021; 84:87-93. [PMID: 34614401 DOI: 10.1016/j.jinf.2021.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aims to search for reliable serological biomarkers allowing the early prediction of cystic echinococcosis (CE) post-operative outcomes. METHODS We applied immunoprecipitation (IP) of Echinococcus granulosus protoscolex antigens with pediatric CE patients' plasma collected at 1-month and 1-year post-surgery, followed by Liquid Chromatography with tandem mass spectrometry (LC-MS/MS). We compared IP proteomic content from relapsed patients within the first-year post-surgery (RCE) to cases with no relapses until 3 post-operative years (NRCE). Selected proteins were recombinantly synthesized and assessed for their prognostic performance by Enzyme-linked immunosorbent assay (ELISA). RESULTS A total of 305 immunoreactive parasitic proteins were identified, 59 of which were significantly more abundant in RCE than NRCE for both time-points. Four proteins showed the most promising characteristics for predicting CE outcomes: cytoplasmic malate dehydrogenase (Eg-cMDH), citrate synthase (Eg-CS), annexin A6 and severin. ELISA-IgG against the four markers were significantly lower at 1-year post-surgery than 1-month in NRCE, in contrast to RCE that displayed either stable or higher levels. The Eg-cMDH and Eg-CS showed the best prognostic performance, with respective probabilities of being "relapse-free" of 83% and 81%, if a decrease of IgG levels occurred between 1-month and 1-year post-surgery. CONCLUSION The Eg-cMDH and Eg-CS are promising biomarkers to predict early CE post-surgical outcomes.
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Affiliation(s)
- Eya Ben Salah
- Département de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire LR12ES08, Université de Monastir, Monastir, Tunisia; National French Reference Centre for Echinococcosis, University Hospital, University Bourgogne Franche-Comté, Bd Fleming, Besançon F-25000, France; Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
| | - Coralie Barrera
- National French Reference Centre for Echinococcosis, University Hospital, University Bourgogne Franche-Comté, Bd Fleming, Besançon F-25000, France; Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
| | - Wahiba Sakly
- Département de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire LR12ES08, Université de Monastir, Monastir, Tunisia.
| | - Sana Mosbahi
- Paediatric Surgery Department, Laboratory of Malformative and Tumor Pathology in Children (LR12SP13), Medical School, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Thierry Balliau
- PAPPSO, INRAE, CNRS, AgroParisTech, Université Paris-Saclay, GQE-Le Moulon, Gif-sur-Yvette 91190, France.
| | - Nathalie Franche
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland.
| | - Sabrine Ben Youssef
- Paediatric Surgery Department, Laboratory of Malformative and Tumor Pathology in Children (LR12SP13), Medical School, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Mongi Mekki
- Paediatric Surgery Department, Laboratory of Malformative and Tumor Pathology in Children (LR12SP13), Medical School, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Hamouda Babba
- Département de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire LR12ES08, Université de Monastir, Monastir, Tunisia.
| | - Laurence Millon
- National French Reference Centre for Echinococcosis, University Hospital, University Bourgogne Franche-Comté, Bd Fleming, Besançon F-25000, France; Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
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Baimakhanov Z, Kaniyev S, Serikuly E, Doskhanov M, Askeyev B, Baiguissova D, Skakbayev A, Sadykov C, Barlybay R, Seisembayev M, Baimakhanov B. Radical versus conservative surgical management for liver hydatid cysts: A single-center prospective cohort study. JGH Open 2021; 5:1179-1182. [PMID: 34622005 PMCID: PMC8485413 DOI: 10.1002/jgh3.12649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/02/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM We prospectively compared the clinical outcomes of radical and conservative surgical procedures for primary liver hydatid cysts, additionally radical surgical procedures with and without the two-month administration of albendazole after the operation were compared. METHODS Overall, 90 patients undergoing open surgical treatment for liver hydatid cysts were divided into three surgical groups: first group, patients who underwent radical surgery (pericystectomy) followed by albendazole treatment for 2 months following the operation group; second group, patients who underwent radical surgery(pericystectomy) without receiving albendazole after surgery group; third group, patients, who underwent conservative surgery (partial cystectomy) with albendazole treatment after surgery. The clinical outcomes and rate of recurrence were analyzed in follow-up period. RESULTS The mean surgery duration in the Radical groups was significantly longer in comparison to the Conservative surgery + Albendazole group. (212.0 and 202.5 min vs. 173.2 min; p < 0.05). Blood loss in the Radical groups was significantly higher in comparison to the Conservative surgery + Albendazole group (218.3 and 174.6 ml vs. 67.2 ml; p < 0.05). However, postoperative complication rate in the Radical group was significantly lower in comparison to Conservative surgery + Albendazole group (13.3% [n = 4] and 6.7% [n = 2] vs. 36% [n = 11]; p < 0.05). The postoperative hospital stay in both Radical groups was significantly lower in comparison to the Conservative surgery + Albendazole group (7.9 and 7.4 days vs. 11.3 days; p < 0.05). CONCLUSION In comparison to conservative surgery, radical surgery is a preferable treatment modality for patients with active liver hydatid cysts. Postoperative albendazole treatment is preferable, regardless of the type of surgical procedure.
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Affiliation(s)
- Zhassulan Baimakhanov
- Department of HPB Surgery and Liver Transplantation Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
| | - Shokan Kaniyev
- Department of HPB Surgery and Liver Transplantation Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
| | - Erbol Serikuly
- Department of HPB Surgery and Liver Transplantation Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
| | - Maxat Doskhanov
- Department of HPB Surgery and Liver Transplantation Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
| | - Baglan Askeyev
- Department of HPB Surgery and Liver Transplantation Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
| | - Dinara Baiguissova
- Department of Radiology Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
| | - Aidar Skakbayev
- Department of HPB Surgery and Liver Transplantation Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
| | - Chingiz Sadykov
- Department of Radiology Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
| | - Raikhan Barlybay
- Department of Radiology Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
| | - Manas Seisembayev
- Department of HPB Surgery and Liver Transplantation Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
| | - Bolatbek Baimakhanov
- Department of HPB Surgery and Liver Transplantation Syzganov's National Scientific Center of Surgery Almaty Kazakhstan
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Peters L, Burkert S, Grüner B. Parasites of the liver - epidemiology, diagnosis and clinical management in the European context. J Hepatol 2021; 75:202-218. [PMID: 33636243 DOI: 10.1016/j.jhep.2021.02.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 01/22/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022]
Abstract
Parasites in the liver cause significant global morbidity and mortality, as they can lead to recurrent cholangitis, cirrhosis, liver failure and cancer. Due to climate change and globalisation, their incidence is increasing, especially in Europe. The correct diagnosis of a hepatic parasite is often delayed because clinicians are unfamiliar with respective entities. Therefore, in this review, we aim to provide clinicians with a comprehensive clinical picture of hepatic parasites and to bring these neglected parasitic liver diseases to the wider attention of hepatology stakeholders in Europe and around the world.
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Affiliation(s)
- Lynn Peters
- University Hospital of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Sanne Burkert
- University Hospital of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Beate Grüner
- University Hospital of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
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Mardani P, Ezabadi AT, Sedaghat B, Sadjjadi SM. Pulmonary hydatidosis genotypes isolates from human clinical surgery based on sequencing of mitochondrial genes in Fars, Iran. J Cardiothorac Surg 2021; 16:167. [PMID: 34099002 PMCID: PMC8186107 DOI: 10.1186/s13019-021-01547-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE)/hydatidosis is an important neglected parasitic zoonotic disease caused by the metacestode of Echinococcus granulosus s.l. The present study was designed to identify the pulmonary CE species/genotypes in isolated human underwent to surgery in our center in Southern Iran. METHODS The study population of this study were all patients in Fars province who were admitted to Namazi Hospitals for pulmonary hydatid cyst surgery. Thoracic surgery was performed in the thoracic ward and the cyst/s was removed by open surgery via posterolateral or lateral thoracotomy. DNA was extracted from the germinal layer or the protoscoleces. PCR technique was performed using the cytochrome C oxidase subunit1 (cox1) gene, and the products were sequenced. RESULTS A total of 32 pulmonary hydatid cyst samples were collected from 9 (28%) female and 23 (72%) male aged from 4 to 74 years old. A total of 18(56%) cyst/s were in the left lobe and 14 (44%) cysts in the right lobe. Sequence analysis of the cysts showed that 24 samples (75%) were E. granulosus s.s (G1-G3) genotype and 8 (25%) were E. canadensis (G6/G7) genotype. CONCLUSION E.granulosus s.s genotype was the most prevalent genotype followed by E. canadensis (G6/G7) genotype. There was no significant statistical correlation between cysts' size, location, genotype strain, and patients' age and gender.
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Affiliation(s)
- Parviz Mardani
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.,Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Talebi Ezabadi
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahareh Sedaghat
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mahmoud Sadjjadi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Al-Saeedi M, Ramouz A, Khajeh E, El Rafidi A, Ghamarnejad O, Shafiei S, Ali-Hasan-Al-Saegh S, Probst P, Stojkovic M, Weber TF, Hoffmann K, Mehrabi A. Endocystectomy as a conservative surgical treatment for hepatic cystic echinococcosis: A systematic review with single-arm meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009365. [PMID: 33979343 PMCID: PMC8143402 DOI: 10.1371/journal.pntd.0009365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 05/24/2021] [Accepted: 04/06/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND In patients with hepatic cystic echinococcosis (CE), treatment effectiveness, outcomes, complications, and recurrence rate are controversial. Endocystectomy is a conservative surgical approach that adequately removes cyst contents without loss of parenchyma. This conservative procedure has been modified in several ways to prevent complications and to improve surgical outcomes. This systematic review aimed to evaluate the intraoperative and postoperative complications of endocysectomy for hepatic CE as well as the hepatic CE recurrence rate following endocystectomy. METHODS A systematic search was made for all studies reporting endocystectomy to manage hepatic CE in PubMed, Web of Science, and Cochrane CENTRAL databases. Study quality was assessed using the methodological index for non-randomized studies (MINORS) criteria and the Cochrane revised tool to assess risk of bias in randomized trials (RoB2). The random-effects model was used for meta-analysis and the arscine-transformed proportions were used to determine complication-, mortality-, and recurrence rates. This study is registered with PROSPERO (number CRD42020181732). RESULTS Of 3,930 retrieved articles, 54 studies reporting on 4,058 patients were included. Among studies reporting preoperative anthelmintic treatment (31 studies), albendazole was administered in all of them. Complications were reported in 19.4% (95% CI: 15.9-23.2; I2 = 84%; p-value <0.001) of the patients; biliary leakage (10.1%; 95% CI: 7.5-13.1; I2 = 81%; p-value <0.001) and wound infection (6.6%; 95% CI: 4.6-9; I2 = 27%; p-value = 0.17) were the most common complications. The post-endocystectomy mortality rate was 1.2% (95% CI: 0.8-1.8; I2 = 21%; p-value = 0.15) and the recurrence rate was 4.8% (95% CI: 3.1-6.8; I2 = 87%; p-value <0.001). Thirty-nine studies (88.7%) had a mean follow-up of more than one year after endocystectomy, and only 14 studies (31.8%) had a follow-up of more than five years. CONCLUSION Endocystectomy is a conservative and feasible surgical approach. Despite previous disencouraging experiences, our results suggest that endocystectomy is associated with low mortality and recurrence.
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Affiliation(s)
- Mohammad Al-Saeedi
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Ali Ramouz
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Elias Khajeh
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Ahmad El Rafidi
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Omid Ghamarnejad
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Saeed Shafiei
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Sadeq Ali-Hasan-Al-Saegh
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Pascal Probst
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Marija Stojkovic
- Section of Clinical Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Tim Frederik Weber
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Liver Cancer Center Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
| | - Katrin Hoffmann
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
- Liver Cancer Center Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
| | - Arianeb Mehrabi
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
- Liver Cancer Center Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
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Tamarozzi F, Silva R, Fittipaldo VA, Buonfrate D, Gottstein B, Siles-Lucas M. Serology for the diagnosis of human hepatic cystic echinococcosis and its relation with cyst staging: A systematic review of the literature with meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009370. [PMID: 33909640 PMCID: PMC8081258 DOI: 10.1371/journal.pntd.0009370] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 04/07/2021] [Indexed: 01/13/2023] Open
Abstract
Background The diagnosis of cystic echinococcosis (CE) is primarily based on imaging, while serology should be applied when imaging is inconclusive. CE cyst stage has been reported among the most important factors influencing the outcome of serodiagnosis. We performed a systematic review and meta-analysis of the relation between cyst stage of hepatic CE and diagnostic sensitivity of serological tests, to evaluate whether their relation is a consistent finding and provide guidance for the interpretation of results of serological tests. Methodology/Principal findings MEDLINE, EMBASE, CENTRAL, and Lilacs databases were searched on December 1st 2019. Original studies published after 2003 (year of publication of the CE cyst classification), reporting sensitivity of serological tests applied to the diagnosis of human hepatic CE, as diagnosed and staged by imaging, were included. The quality of studies was assessed using the Newcastle-Ottawa Scale. Data from 14 studies were included in the meta-analysis. Summary estimates of sensitivities and 95% confidence intervals were obtained using random effects meta-analysis. Overall, test sensitivity was highest in the presence of CE2 and CE3 (CE3a and/or CE3b), and lowest in the presence of CE5 and CE4 cysts. ELISA, ICT and WB showed the highest sensitivities, while IHA performed worst. Conclusions/Significance The results of our study confirm the presence of a clear and consistent relation between cyst stage and serological tests results. Limitations of evidence included the heterogeneity of the antigenic preparations used, which prevented to determine whether the relation between cyst stage and sensitivity was influenced by the type of antigenic preparation, the paucity of studies testing the same panel of sera with different assays, and the lack of studies assessing the performance of the same assay in both field and hospital-based settings. Our results indicate the absolute need to consider cyst staging when evaluating serological results of patients with hepatic CE. Cystic echinococcosis is a neglected zoonosis induced by the development of parasitic cysts in intermediate hosts, including humans, mostly in the liver. The diagnosis of CE is based on imaging. As CE cysts may assume different aspects (stages), the range of differential diagnoses is broad, from harmless simple cysts to neoplasms. Serological assays for the detection of serum antibodies are applied when imaging is inconclusive, but their performance depend on a number of factors, among which cyst stage has been reported as important. If this was a robust finding, it would be absolutely required to interpret serological findings in the light of CE cyst staging. The results of our systematic review and meta-analysis of the relation between cyst stage of hepatic CE and diagnostic sensitivity of serological tests confirmed that such relation is clear and consistent, and indicate the absolute need to consider cyst staging when evaluating serology results of patients with hepatic CE.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
- * E-mail:
| | - Ronaldo Silva
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Veronica Andrea Fittipaldo
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Bruno Gottstein
- Institute of Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Salamanca, Spain
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Vuruskan E, Ercil H, Anil H, Unal U, Ortoglu F, Karkin K, Ayhan L, Gurbuz ZG. Comparison of Laparoscopic and Open Surgery in the Treatment of Renal Hydatid Cysts. J Laparoendosc Adv Surg Tech A 2021; 32:427-431. [PMID: 33844958 DOI: 10.1089/lap.2021.0031] [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: 11/12/2022] Open
Abstract
Background: To compare the efficacy, safety, and long-term results of laparoscopic and open approaches in patients undergoing surgery for renal hydatid cyst. Materials and Methods: The files of 36 patients who were surgically treated in our clinic and with diagnosis of renal cyst hydatid confirmed pathologically were reviewed. According to the surgical technique applied, the patients were divided into two groups as open (group 1) or laparoscopic (group 2) partial pericystectomy. Oral albendazole was given 10 mg/kg/day (in two divided doses) for 4 weeks preoperatively and for three cycles of 4 weeks at 1-week intervals after surgery in all patients. Demographic characteristics, laboratory and imaging findings, operation times, hospitalization times, complications, intraoperative bleeding amounts, and recurrence rates were statistically compared in both groups. Results: Open partial pericystectomy was performed in 21 patients in group 1, and laparoscopic transperitoneal partial pericystectomy was performed in 15 patients in group 2. Operation time and intraoperative bleeding amount in group 1 and group 2 were 119.6 ± 17.1/116.1 ± 17.6 minutes and 125.7 ± 27.8/113.9 ± 19.2 mL, respectively. There was no statistically significant difference between these values (P = .557, P = .167, respectively). Hospitalization duration of both groups was 5.9 ± 1.4/3.6 ± 0.7 days, respectively. Hospitalization duration in group 2 was statistically significantly shorter (P < .001). No recurrence occurred during postoperative follow-up in either group. Conclusions: In the treatment of renal hydatid cysts, laparoscopy, which is a minimally invasive approach, can be technically applied with the same principles as open surgery and has a similar efficacy and safety profile for short- and long-term results.
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Affiliation(s)
- Ediz Vuruskan
- Department of Urology, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey
| | - Hakan Ercil
- Department of Urology, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey
| | - Hakan Anil
- Department of Urology, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey
| | - Umut Unal
- Department of Urology, Adana Seyhan State Hospital, Adana, Turkey
| | - Ferhat Ortoglu
- Department of Urology, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey
| | - Kadir Karkin
- Department of Urology, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey
| | - Lokman Ayhan
- Department of Urology, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey
| | - Zafer Gokhan Gurbuz
- Department of Urology, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey
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Sadjjadi FS, Ahmadi N, Rezaie-Tavirani M, Zali H. Following up of Surgical Treated Human Liver Cystic Echinococcosis: A Proteomics Approach. IRANIAN JOURNAL OF PARASITOLOGY 2021; 16:11-22. [PMID: 33786043 PMCID: PMC7988678 DOI: 10.18502/ijpa.v16i1.5507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Cystic echinococcosis (CE) is one of the most important parasitic zoonosis in the world. Post-surgery follow up in CE patients is an important non-solved problem up to now. Therefore, the investigations on this problematic issue would be very applicable in the view of CE clinical treatment. Methods: A total of 24 confirmed liver CE patients sera including eight sera before surgery (BS), eight sera three months post-surgery (3MPS), and eight sera six months post-surgery (6MPS) were used in the present study. Proteomics methods including 2DE and LC-MS/MS were performed on the specimens followed by bioinformatics analysis such as Gene Ontology (GO) and Protein-Protein Interaction (PPI) network analysis. Results: A total of 235 proteins were detected of which 12 differentially expressed proteins (DEP) were identified by LC-MS/MS in all sera. The proteins were presented in BS and suppressed after surgery as follows: HPX, SERPINA1, SERPINC1, CP, HBD, and HBA2. Comparisons of the protein expression in sera of patients BS, 3MPS, and 6MPS revealed that GC, IGJ, AHSG, CD5L, FGG, and APOC3 have been overexpressed in 3MPS and 6MPS. PPI network analysis demonstrated that SERPINC1 and AHSG with more connection in the network could be considered as hub proteins and potential prognostic biomarkers in response to surgical treatment of liver CE. Conclusion: Application of proteomics methods on patient’s sera could be used as a novel biomarker tool for following-up liver CE patients. In this regards, proteomics and, application of bioinformatics analysis including GO and PPI showed that SERPINC1, AHSG and HPX are of more value as a potential follow up biomarkers in response to surgical treatment.
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Affiliation(s)
- Fatemeh Sadat Sadjjadi
- Department of Basic Sciences, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nayebali Ahmadi
- Proteomics Research Center, Department of Medical Lab Technology, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Rezaie-Tavirani
- Proteomics Research Center, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hakimeh Zali
- School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tamarozzi F, Longoni SS, Vola A, Degani M, Tais S, Rizzi E, Prato M, Scarso S, Silva R, Brunetti E, Bisoffi Z, Perandin F. Evaluation of Nine Commercial Serological Tests for the Diagnosis of Human Hepatic Cyst Echinococcosis and the Differential Diagnosis with Other Focal Liver Lesions: A Diagnostic Accuracy Study. Diagnostics (Basel) 2021; 11:diagnostics11020167. [PMID: 33503986 PMCID: PMC7911993 DOI: 10.3390/diagnostics11020167] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/19/2022] Open
Abstract
The differential diagnosis of hepatic cystic echinococcosis (CE) may be challenging. When imaging is insufficient, serology can be applied, but no consensus diagnostic algorithm exists. We evaluated the performances of nine serological tests commercialized in Europe for the diagnosis of “echinococcosis”. We performed a diagnostic accuracy study using a panel of sera from patients with hepatic CE (n = 45 “liquid” content stages, n = 25 “solid” content stages) and non-CE focal liver lesions (n = 54 with “liquid” content, n = 11 with “solid” content). The diagnosis and staging of CE were based on ultrasound (gold standard). Nine commercial seroassays (5 ELISA, 2 WB, 1 Chemiluminescence Immunoassay [CLIA] and 1 Immunochromatographic test [ICT]) were the index tests. Sensitivity (Se) ranged from 43 to 94% and from 31 to 87%, and specificity (Sp) from 68 to 100% and from 94 to 100%, when borderline results were considered positive or negative, respectively. Three seroassays (2 ELISA, 1 WB) were excluded from further analyses due to poor performances. When tests were combined, Sp was 98–100%. The best results were obtained using the WB-LDBIO alone (Se 83%) or as a third test after two non-WB tests (Se 67–86%). A validated WB or two non-WB tests, read with stringent criteria (borderline = negative and considered positive only if concordant positive), possibly confirmed by the WB, appear sensible approaches.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy; (S.S.L.); (M.D.); (S.T.); (E.R.); (M.P.); (S.S.); (R.S.); (Z.B.); (F.P.)
- Correspondence: ; Tel.: +39-0456013226
| | - Silvia Stefania Longoni
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy; (S.S.L.); (M.D.); (S.T.); (E.R.); (M.P.); (S.S.); (R.S.); (Z.B.); (F.P.)
| | - Ambra Vola
- Department of Medical Sciences and Infectious Diseases, IRCCS San Matteo Hospital Foundation, 27100 Pavia, Italy; (A.V.); (E.B.)
| | - Monica Degani
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy; (S.S.L.); (M.D.); (S.T.); (E.R.); (M.P.); (S.S.); (R.S.); (Z.B.); (F.P.)
| | - Stefano Tais
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy; (S.S.L.); (M.D.); (S.T.); (E.R.); (M.P.); (S.S.); (R.S.); (Z.B.); (F.P.)
| | - Eleonora Rizzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy; (S.S.L.); (M.D.); (S.T.); (E.R.); (M.P.); (S.S.); (R.S.); (Z.B.); (F.P.)
| | - Marco Prato
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy; (S.S.L.); (M.D.); (S.T.); (E.R.); (M.P.); (S.S.); (R.S.); (Z.B.); (F.P.)
| | - Salvatore Scarso
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy; (S.S.L.); (M.D.); (S.T.); (E.R.); (M.P.); (S.S.); (R.S.); (Z.B.); (F.P.)
| | - Ronaldo Silva
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy; (S.S.L.); (M.D.); (S.T.); (E.R.); (M.P.); (S.S.); (R.S.); (Z.B.); (F.P.)
| | - Enrico Brunetti
- Department of Medical Sciences and Infectious Diseases, IRCCS San Matteo Hospital Foundation, 27100 Pavia, Italy; (A.V.); (E.B.)
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Zeno Bisoffi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy; (S.S.L.); (M.D.); (S.T.); (E.R.); (M.P.); (S.S.); (R.S.); (Z.B.); (F.P.)
- Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy
| | - Francesca Perandin
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy; (S.S.L.); (M.D.); (S.T.); (E.R.); (M.P.); (S.S.); (R.S.); (Z.B.); (F.P.)
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Hosseini Shabanan S, Dashti SH, Abbasi M, Jafarian A, Ebrahimi A, Ayoobi Yazdi N. Retrospective Review of Complications of Liver Hydatid Cyst Surgery with Emphasis on Outcomes of Omentoplasty. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:488-494. [PMID: 33884005 PMCID: PMC8039479 DOI: 10.18502/ijpa.v15i4.4853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background The outcome and complications of liver hydatid cyst surgeries with new and old techniques are not well determined. We intended to present the results of operations done for patients with hepatic hydatid cyst in an endemic area. Methods Data of 112 patients referred and operated for liver hydatid cyst, in Imam Khomeini Hospital complex, Tehran, Iran, from 2015 to 2018, were collected including demographic characteristics, operation parameters and complication related statistics. The variables were presented for different surgical methods including operations with and without omentoplasty. Results Patients aged 39. 3 ± 13. 9 yr (70 females; 63. 5%). Most frequent clinical complaint was vague abdominal pain (n=45; 40. 2%). The most prevalent comorbidity was hypertension (18; 16.0%). Conservative methods were chosen more frequently including omentoplasty (44; 39. 3%), cyst drainage (27; 24. 1%), cyst resection (19; 17%) and marsupialization (3; 2. 7%). Overall, 56 patients (50%) were operated with omentoplasty as the single method or in combination with segmentectomy. Complications occurred less in patients operated with omentoplasty (41. 1 vs. 23. 2%; P=0. 043); particularly, biloma was more frequent in surgeries without omentoplasty (7. 1 vs 0. 0%; P=0. 042). Persistence and recurrence rates were 12. 5% and 3. 6% with relative predilection in, respectively, segmentectomy and lobectomy surgical methods compared to Omentoplasty. No mortality was recorded. Conclusions In our case series of hepatic hydatid cyst patients, omentoplasty was safe with less complication and similar long-term recurrence rate.
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Affiliation(s)
- Sedighe Hosseini Shabanan
- Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Habibollah Dashti
- Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrshad Abbasi
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Jafarian
- Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirpasha Ebrahimi
- Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Ayoobi Yazdi
- Advanced Diagnostic and Interventional Radiology (ADIR) Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Villalobos N, Cabanilla MG, Diehl WP. Primary pulmonary cystic Echinococcus in an immunocompetent patient. BMJ Case Rep 2020; 13:13/8/e234578. [PMID: 32843399 DOI: 10.1136/bcr-2020-234578] [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: 11/03/2022] Open
Abstract
A 60-year-old man was referred to the interventional pulmonology clinic with a large right-sided intraparenchymal lung mass and a second, smaller lesion in the left lower lobe, accompanied by intermittent haemoptysis, fever, chills, productive cough of white phlegm as well as dizziness and weakness. He had presented previously and was being evaluated for the possibility of malignancy. Investigations had revealed 'hooklets' (protoscolices) of hydatid cysts, most likely representing the parasite Echinococcus Successful surgical excision of the affected lobe, lung decortication, partial pleurectomy and pneumolysis of the adhesions was performed, along with long-term antiparasitic therapy. The initial differential diagnosis for this patient was challenging and required multimodal investigations. The patient made good recovery and continued to be followed by infectious disease specialists for management of antiparasitic therapy.
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Affiliation(s)
- Nicholas Villalobos
- Pulmonary, Critical Care, and Sleep Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | | | - William Paul Diehl
- Pulmonary, Critical Care, and Sleep Medicine, University of New Mexico, Albuquerque, New Mexico, USA
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Autochthonous liver cystic hydatid: Past or actual French shepherd's disease? IDCases 2020; 21:e00843. [PMID: 32509529 PMCID: PMC7264046 DOI: 10.1016/j.idcr.2020.e00843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/22/2020] [Accepted: 05/22/2020] [Indexed: 12/28/2022] Open
Abstract
Autochthonous hydatidosis in France and western Europa are uncommon since the beginning of the 21st century. We report here an authentic indigenous cystic echinococcosis case in a French shepherd. The risk of remerging pathology should not be neglected and measures to interrupt parasite transmission are still relevant.
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Kuzmanovska B, Kartalov A, Kuzmanovski I, Shosholcheva M, Jankulovski N, Gavrilovska-Brzanov A, Dimitrovski A, Cvetkovska E. Hypernatremia-induced Neurologic Complications After Hepatic Hydatid Cyst Surgery: Pretreat to Prevent. Med Arch 2020; 73:356-358. [PMID: 31819311 PMCID: PMC6885227 DOI: 10.5455/medarh.2019.73.356-358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Introduction: Surgery is effective treatment for echinococcosis; however, there is a risk of hypertonic saline resorption and acute hypernatremia. Aim: We report two cases of severe hypernatremia following hydatid cyst removal. Case reports: A 17-year-old girl underwent surgical removal of hepatic hydatid cyst. Following the surgery, she developed seizures evolving to status epilepticus, and was sedated and mechanically ventilated. Blood chemistry showed hypernatremia. Fluid resuscitation with 5% dextrose infusions was started in combination with furosemide. Electrolytes were monitored frequently until plasma sodium levels normalized, 30 hours later. The patient was seizure free 48 hours later. The second patient is a 70-year-old man with hepatic hydatid cyst. After the surgery he became somnolent and confused due to severe hypernatremia. Intravenous administration of five percentage dextrose was initiated and high doses of furosemide. Sodium level normalized within 38 hours. The patient’s mental status improved. Conclusion: A hospital protocol was established aiming to prevent hypernatremia and neurological complications.
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Affiliation(s)
- Biljana Kuzmanovska
- University Clinic for Anaesthesiology, Reanimation and Intensive Care Medicine, Medical Faculty, Ss Cyril and Methodius University, Skopje, N Macedonia
| | - Andrijan Kartalov
- University Clinic for Anaesthesiology, Reanimation and Intensive Care Medicine, Medical Faculty, Ss Cyril and Methodius University, Skopje, N Macedonia
| | - Igor Kuzmanovski
- University Clinic of Neurology, Medical Faculty, Ss Cyril and Methodius University, Skopje, N Macedonia
| | - Mirjana Shosholcheva
- University Surgical Clinic St Naum Ohridski,Medical Faculty, Ss Cyril and Methodius University, 1000 Skopje, N Macedonia
| | - Nikola Jankulovski
- University Clinic for Digestive Surgery, Medical Faculty, Ss Cyril and Methodius University, 1000, Skopje, N Macedonia
| | - Aleksandra Gavrilovska-Brzanov
- University Clinic for Anaesthesiology, Reanimation and Intensive Care Medicine, Medical Faculty, Ss Cyril and Methodius University, Skopje, N Macedonia
| | - Aleksandar Dimitrovski
- University Clinic for Anaesthesiology, Reanimation and Intensive Care Medicine, Medical Faculty, Ss Cyril and Methodius University, Skopje, N Macedonia
| | - Emilija Cvetkovska
- University Clinic of Neurology, Medical Faculty, Ss Cyril and Methodius University, Skopje, N Macedonia
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Comprehensive characterization of plasma cell-free Echinococcus spp. DNA in echinococcosis patients using ultra-high-throughput sequencing. PLoS Negl Trop Dis 2020; 14:e0008148. [PMID: 32282820 PMCID: PMC7209354 DOI: 10.1371/journal.pntd.0008148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 05/08/2020] [Accepted: 02/18/2020] [Indexed: 12/18/2022] Open
Abstract
Background Echinococcosis is a life-threatening parasitic disease caused by Echinococcus spp. tapeworms with over one million people affected globally at any time. The Echinococcus spp. tapeworms in the human body release DNA to the circulatory system, which can be a biomarker for echinococcosis. Cell-free DNA (cfDNA) is widely used in medical research and has been applied in various clinical settings. As for echinococcosis, several PCR-based tests had been trialed to detect cell-free Echinococcus spp. DNA in plasma or serum, but the sensitivity was about 20% to 25%. Low sensitivity of PCR-based methods might be related to our limited understanding of the features of cell-free Echinococcus spp. DNA in plasma, including its concentration, fragment pattern and release source. In this study, we applied ultra-high-throughput sequencing to comprehensively investigate the characteristics of cell-free Echinococcus spp. DNA in plasma of echinococcosis patients. Methodology/Principal findings We collected plasma samples from 23 echinococcosis patients. Total plasma cfDNA was extracted and sequenced with a high-throughput sequencing platform. An average of 282 million read pairs were obtained for each plasma sample. Sequencing data were analyzed with bioinformatics workflow combined with Echinococcus spp. sequence database. After identification of cell-free Echinococcus spp. reads, we found that the cell-free Echinococcus spp. reads accounted for 1.8e-5 to 4.0e-9 of the total clean reads. Comparing fragment length distribution of cfDNA between Echinococcus spp. and humans showed that cell-free Echinococcus spp. DNA of cystic echinococcosis (CE) had a broad length range, while that of alveolar echinococcosis (AE) had an obvious peak at about 135 bp. We found that most of the cell-free Echinococcus spp. DNA reads were from the nuclear genome with an even distribution, which might indicate a random release pattern of cell-free Echinococcus spp. DNA. Conclusions/Significance With ultra-high-throughput sequencing technology, we analyzed the concentration, fragment length, release source, and other characteristics of cell-free Echinococcus spp. DNA in the plasma of echinococcosis patients. A better understanding of the characteristics of cell-free Echinococcus spp. DNA in plasma may facilitate their future application as a biomarker for diagnosis. Echinococcosis is one of the most neglected tropical diseases caused by the metacestodes of Echinococcus spp. tapeworms, which affect both humans and livestock. Plasma cell-free DNA (cfDNA) consists of nucleic acid fragments found extracellularly and may contain DNA released from the parasites. Research shows that a variety of parasites can be detected from plasma cfDNA. Cell-free Echinococcus spp. DNA in plasma or serum had been tested with PCR-based methods, but these PCR methods had low sensitivity ranged from 20% to 25%. Low sensitivity may be due to our limited understanding of cell-free Echinococcus spp. DNA in plasma. Here, we take advantage of high-throughput sequencing to get a comprehensive characterization of cell-free Echinococcus spp. DNA. Our results showed that with high-throughput sequencing we could detect cell-free Echinococcus spp. DNA in all samples, though at a very low level. Based on the sequencing data, we found that cell-free Echinococcus spp. DNA in plasma had a different fragment length distribution to cell-free human DNA, and fragment length distribution of cell-free Echinococcus spp. DNA is also different between cystic echinococcosis (CE) and alveolar echinococcosis (AE). The sequencing data can also help trace the release source of cell-free Echinococcus spp. DNA from the genome. According to the mapping results of cell-free Echinococcus spp. DNA reads, we found that most of them were from the nuclear genome rather than the mitochondrial genome, and their release position showed an even distribution on the genome. These characteristics of cell-free Echinococcus spp. DNA in echinococcosis patients’ plasma could facilitate their future application in research or clinical settings.
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Al-Saeedi M, Khajeh E, Hoffmann K, Ghamarnejad O, Stojkovic M, Weber TF, Golriz M, Strobel O, Junghanss T, Büchler MW, Mehrabi A. Standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis. PLoS Negl Trop Dis 2019; 13:e0007516. [PMID: 31226109 DOI: 10.1371/journal.pntd.0007516] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/03/2019] [Accepted: 06/05/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Two surgical options are available for cystic echinococcosis (CE). The two principal approaches are radical (resection of the cyst) and conservative (evacuation of the cyst content and partial removal of the cyst capsule). Here, we describe a standardized endocystectomy technique for hepatic echinococcosis. SUBJECTS AND METHODS Twenty-one patients (male/female: 4/3; median age: 28 years) with uncomplicated, isolated hepatic CE (cyst stages WHO CE1, 2, 3a, and 3b) that were treated with the standardized endocystectomy described in this paper. Before the operation and during the follow-up period (mean: 33.8 months, median: 24 months), patients underwent clinical and sonographical and/or magnetic resonance imaging assessment during regular visits managed by an interdisciplinary team. RESULTS Forty-seven cysts were treated with the standardized endocystectomy technique. The median number of cysts per patient was two (range: 1-8). Nine patients (43%) had a single cystic lesion. The median operation time was 165 minutes and the median intraoperative bleeding volume was 200 mL. The median hospital stay was nine days (range: 6-28 days). Morbidity (Clavien-Dindo III) occurred in four patients (19%). No mortality and no recurrence were found during the median follow-up time of 24 months. CONCLUSIONS The standardized endocystectomy technique presented is a safe procedure with acceptable morbidity, no mortality, and without recurrences in our patient series. Important components of our CE management are interdisciplinary patient care, adequate diagnostic work-ups, and regular pre- and postoperative visits, including long-term follow-up for early and reliable capture of recurrences.
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Affiliation(s)
- Mohammed Al-Saeedi
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Elias Khajeh
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Katrin Hoffmann
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Omid Ghamarnejad
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Marija Stojkovic
- Section of Clinical Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Tim F Weber
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Mohammad Golriz
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Oliver Strobel
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Thomas Junghanss
- Section of Clinical Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Markus W Büchler
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Arianeb Mehrabi
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
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