Hidatidosis mesentérica y hepática en la costa caribe colombiana. Reporte de caso / Mesenteric and hepatic hydatid disease on the Colombian Caribbean coast. Case report

Introducción. La hidatidosis o equinococosis es una zoonosis parasitaria que se adquiere al ingerir huevos de cestodos del género Echinococcus. El diagnóstico clínico raramente se hace en sitios no endémicos. La mayoría de los pacientes se encuentran asintomáticos y los hallazgos incidentales en los estudios de imágenes o en procedimientos quirúrgicos permiten la sospecha diagnóstica. Caso clínico. Paciente masculino de 70 años, residente en área rural del municipio de Puerto Libertador, departamento de Córdoba, Colombia, quien consultó por masa abdominal en epigastrio y mesogastrio, parcialmente móvil e indolora. Resultados. En cirugía se identificaron lesiones quísticas mesentérica y hepática. Después de la cirugía y mediante estudios de inmunohistoquímica, se confirmó el diagnóstico de quiste hidatídico. El paciente tuvo una evolución satisfactoria. Conclusión. La hidatidosis quística mesentérica y hepática sintomática es una enfermedad rara en sitios no endémicos, donde la cirugía constituye un pilar fundamental en el diagnóstico y tratamiento, sumado al manejo médico farmacológico.

Introduction. Hydatidosis or echinococcosis is a parasitic zoonosis that is acquired by ingesting eggs of cestodes of the genus Echinococcus. Clinical diagnosis is rarely made in non-endemic sites. Most patients are asymptomatic and incidental findings on imaging studies or surgical procedures allow for diagnostic suspicion. Clinical case. A 70-year-old male patient, resident in a rural area of the municipality of Puerto Libertador, department of Córdoba, Colombia, who consulted for an abdominal mass in the epigastrium and mesogastrium, partially mobile and painless. Results. In surgery, mesenteric and hepatic cystic lesions were identified. After surgery and through immunohistochemistry studies, the diagnosis of hydatid cyst was confirmed. The patient had a satisfactory evolution. Conclusion. Symptomatic mesenteric and hepatic cystic hydatidosis is a rare disease in non-endemic sites, where surgery constitutes a fundamental pillar in the diagnosis and treatment in addition to pharmacological medical management.

Hepatic alveolar echinococcosis simulating metastatic malignancy

ABSTRACT Echinococcosis is a parasitic disease caused by infection with tiny tapeworms of the genus Echinococcus. Echinococcosis is classified as either cystic echinococcosis or alveolar echinococcosis. The common form is a zoonosis from goats and sheep that tends to cause liver lesions. The larval stage of Echinococcus multilocularis causes alveolar echinococcosis/alveolar hydatid disease. It is a zoonosis with field mice and tundra voles as intermediate and wild carnivores like foxes and wolves as definitive hosts. This zoonosis is highly uncommon compared to the other form known as cystic echinococcosis but poses a great human threat if untreated. We report the case of a young man who was working in the Kashmir Valley, North India, and presented with jaundice and right upper quadrant abdominal pain. Computed tomography revealed a large solid-cystic intrahepatic lesion measuring 125x118x123 mm, suggestive of a malignant tumor with central necrosis. A liver biopsy showed necrosis with PAS-positive membranes morphologically consistent with echinococcosis. Alveolar echinococcosis can present as a solid-cystic mass in the liver and can simulate metastatic malignancy.

Intervención educativa en una enfermedad desatendida: hidatidosis/ equinococosis quística en escolares del norte de Chile

Introducción: La hidatidosis es una zoonosis cuyo control más eficiente y eficaz es la promoción en salud, especialmente en la población infante-juvenil. Objetivo: Medir el impacto de un programa de intervención educativa sobre hidatidosis en escolares del norte de Chile. Método: Estudio intervencional educativo con fases pre y post test en 3.145 estudiantes de educación preescolar, primaria y secundaria de tres comunas. Se definieron dimensiones, unidades educativas y sistemas de evaluación incorporados en las bases curriculares. Se calculó el puntaje de logro de respuestas correctas utilizando la prueba t. Se estimó el tamaño del efecto mediante d de Cohen y análisis de varianza mixto. Resultados: Se encontraron diferencias estadísticamente significativas en la muestra total y en las variables género, comuna, procedencia rural-urbana y nivel de educación. Los puntajes post intervención fueron mayores y con tamaños de efecto grandes a excepción de los primeros niveles de educación. Se hallaron puntajes mayores post test y efectos de interacción con diferencias significativas en rural-urbano y en comuna anteriormente intervenida. La dimensión mejor evaluada fue "medidas de autocuidado" y la más baja "tenencia responsable de perros". Conclusiones: El programa educativo fue efectivo al ser dirigido a grupos etarios, mediante métodos pedagógicos en las bases curriculares de los establecimientos educacionales.

Background: Hydatidosis is a zoonosis whose most efficient and effective control is health promotion, especially in children and youth. Aim: To measure the impact of an educational intervention program on hydatidosis in schoolchildren in northern Chile. Method: Educational interventional study was performed with pre-post test phases in 3,145 students of preschool, primary and secondary education from three districts. Dimensions, educational units and evaluation systems were defined and incorporated into the curricular bases. The correct answer achievement score was calculated using the T-test. Effect size was estimated using Cohen's d and mixed analysis of variance. Results: Statistically significant differences were found in the total sample and in variables such as gender, district, rural-urban origin and level of education. Post-intervention scores were higher than pre-intervention and with large effect sizes, except for the first levels of education. Higher post-test scores and interaction effects were found with significant differences in rural-urban and in a previously intervened district. The best evaluated dimension was "self-care measures" and the lowest was "responsibly keeping dogs". Conclusions: The educational program was effective when directed to age groups, through pedagogical methods in the curricular bases of educational facilities.

Estrategias de control de la Equinococosis quística en el Uruguay / Strategies for the control of cystic echinococcosis in Uruguay / Estratégias de controle da equinococose cística no Uruguai

La equinococosis quística es una zoonosis de origen parasitario con distribución cosmopolita. En nuestro país continúa siendo una enfermedad endémica, afectando principalmente pequeños centros poblados y áreas rurales pobres relacionadas a la producción ovina. Los planes de control requieren de un abordaje holístico, con la participación de diferentes instituciones, profesionales y en especial de la comunidad. La cooperación regional busca monitorizar el avance de la enfermedad y centrar las medidas de acción sobre cuatro ejes, definidos según los puntos de intervención más comunes para la quiebra del ciclo de transmisión y la consecuente reducción en incidencia y prevalencia de la enfermedad. La presente revisión utilizó literatura obtenida en diferentes bases de datos, bibliotecas virtuales y sitios web regionales y locales con el objetivo describir las principales estrategias de control, vigilancia y prevención aplicadas actualmente en nuestro país.

Cystic echinococcosis is a zoonosis of parasitic origin with cosmopolitan distribution. In our country it continues to be an endemic disease, affecting mainly small population centers and poor rural areas related to sheep production. Control plans require a holistic approach, with the participation of different institutions, professionals and especially the community. Regional cooperation seeks to monitor the progress of the disease and focus action measures on four axes, defined according to the most common points of intervention to break the transmission cycle and consequently reduce the incidence and prevalence of the disease. This review used literature obtained from different databases, virtual libraries and regional and local websites with the aim of describing the main control, surveillance and prevention strategies currently applied in our country.

A equinococose cística é uma zoonose de origem parasitária com distribuição cosmopolita. Em nosso país, continua a ser uma doença endêmica, afetando principalmente pequenos centros populacionais e áreas rurais pobres relacionadas à produção de ovinos. Os planos de controle exigem uma abordagem holística, com a participação de diferentes instituições, profissionais e, principalmente, da comunidade. A cooperação regional busca monitorar o progresso da doença e concentrar as medidas de ação em quatro eixos, definidos de acordo com os pontos de intervenção mais comuns para interromper o ciclo de transmissão e, consequentemente, reduzir a incidência e a prevalência da doença. Esta revisão utilizou a literatura obtida em diferentes bases de dados, bibliotecas virtuais e sites regionais e locais com o objetivo de descrever as principais estratégias de controle, vigilância e prevenção aplicadas atualmente em nosso país.

Vigilancia serológica de la zoonosis parasitaria en 13 regiones de la sierra del Perú: Periodo 2016-2019 / Serological surveillance of parasitic zoonoses in 13 highlands regions of Peru: Period 2016-2019

RESUMEN Objetivos. Determinar la seropositividad a anticuerpos anti-IgG por infección de Echinococcus granulosus, Fasciola hepatica y cisticerco de Taenia solium y describir las características de los infectados en 13 regiones de la sierra peruana entre 2016 y 2019. Materiales y métodos. Estudio observacional transversal, que analizó 7811 fichas epidemiológicas de la vigilancia basada en laboratorio de las zoonosis parasitarias del periodo 2016-2019. El diagnóstico se realizó mediante la detección de anticuerpos tipo IgG anti E. granulosus, F. hepatica y cisticerco de T. solium utilizando antígenos nativos mediante el ensayo inmunoabsorbente ligado a enzimas (ELISA) e Inmunoblot. La diferencia en la frecuencia de casos de estas zoonosis según características identificadas se realizó mediante la prueba chi-cuadrado de Pearson y prueba exacta de Fisher. Resultados. Se determinó una seropositividad de 7,9% para fascioliasis, 4,9% para equinococosis quística, y 2,3% para cisticerco de T. solium. Estas frecuencias fueron mayores en Cerro de Pasco para equinococosis quística (24,5%), en Ayacucho para cisticerco de T. solium (4,5%) y en Puno para fascioliasis (40,6%). Entre las características sociodemográficas, se encontró una diferencia estadísticamente significativa en la frecuencia de casos para todas las zoonosis según grupo etario, ocupación, y región de residencia. Además, se encontró diferencia con el consumo de verduras en emolientes, y entre las características clínico-epidemiológicas con tener antecedentes familiares de las zoonosis parasitarias. Conclusiones. A partir de las 7811 muestras evaluadas, se encontró que estas zoonosis parasitarias están distribuidas en 13 regiones de la sierra del Perú, ocasionando un problema de salud importante, con frecuencias que varían según diversas características.

ABSTRACT Objectives. To determine seropositivity to anti-IgG antibodies against Echinococcus granulosus, Fasciola hepatica and Taenia solium cysticercus infection and to describe the characteristics of the infected patients in 13 regions of the Peruvian highlands between 2016 and 2019. Materials and methods. Cross-sectional, observational study, in which we analyzed 7811 epidemiological records of laboratory-based surveillance of parasitic zoonoses from 2016 to 2019. Diagnosis was established by detecting IgG type anti-E. granulosus, F. hepatica and T. solium cysticercus antibodies using native antigens by enzyme-linked immunosorbent assay (ELISA) and Immunoblot. We evaluated the difference in the frequency of the cases according to identified characteristics using Pearson's chi-square test and Fisher's exact test. Results. Seropositivity was 7.9% for fascioliasis, 4.9% for cystic echinococcosis, and 2.3% for T. solium cysticercus. These rates were higher in Cerro de Pasco for cystic echinococcosis (24.5%), in Ayacucho for T. solium cysticercus (4.5%) and in Puno for fascioliasis (40.6%). Regarding the sociodemographic characteristics, we found a statistically significant difference in the frequency of cases for all zoonoses according to age group, occupation, and region of residence. We also found a difference with the consumption of vegetables in emollients, and between clinical-epidemiological characteristics and having a family history of parasitic zoonoses. Conclusions. From the 7811 samples, we found that these parasitic zoonoses are distributed in 13 regions of the Peruvian highlands, and represent a major health problem, with frequencies that change according to different characteristics.

Recurrencia en echinococcosis quística hepática

El tratamiento quirúrgico de la equinococosis quística hepática se asocia (entre otras), con una tasa de recurrencia actual de hasta 27%, aunque es infrecuente la recurrencia después de la exéresis total de un quiste intacto. Por lo general, la recurrencia ocurre producto del derrame de estructuras parasitarias vivas a alguna cavidad, o de dejar residuos de germinal, vesículas hijas o protoescólices durante la cirugía. La recurrencia suele ser asintomática, por lo que el diagnóstico depende, casi exclusivamente, de un seguimiento riguroso y prolongado en el tiempo, con controles clínicos, determinaciones serológicas, e imágenes. El tratamiento puede incluir el uso de albendazol, asociado a técnicas de radiología intervencionista o cirugía. El objetivo de este manuscrito fue generar un documento de lectura referente a la recurrencia de la equinococosis quística hepática.

Surgical treatment of hepatic cystic echinococcosis is associated (among others), with a current recurrence rate of up to 27%; although recurrence after total resection of an intact cyst is rare. In general, recurrence occurs as a result of the spillage of living parasitic structures into a cavity, or of leaving germinal residues, daughter vesicles, or protoscolices during surgery. Recurrence is usually asymptomatic, so the diagnosis depends almost exclusively on a rigorous and prolonged follow-up, with clinical controls, serological determinations, and images. Treatment may include the use of albendazole, followed by interventional radiology techniques or surgery. The aim of this manuscript was to generate a reading document regarding the recurrence of hepatic cystic echinococcosis.

Equinococosis quística peritoneal diseminada en paciente con infección Por VIH: reporte de caso / Disseminated peritoneal cystic Echinococcosis in a patient with HIV: case report

RESUMEN La equinococosis quística es una infección zoonótica producida por la larva de Echinococcus granulosus que es capaz de invadir diversos órganos desde su ubicación en el intestino humano. En los casos de coinfección con el virus de la inmunodeficiencia humana (VIH), existe una diversidad de complicaciones condicionadas por la enfermedad inmunosupresora con pronóstico reservado. El objetivo de este reporte es describir un caso de equinococosis multiquística peritoneal en una paciente en tratamiento antiviral para VIH durante casi diez años, que recibió la combinación de albendazol más cirugía, con evolución favorable. Este reporte sería el primero en el Perú en una persona con inmunosupresión por VIH y equinococosis quística.

ABSTRACT Cystic echinococcosis is a zoonotic infection caused by the larva of Echinococcus granulosus, which is capable of invading several organs starting from the human intestine. There are several complications in cases of co-infection with the human immunodeficiency virus (HIV), which are conditioned by the immunosuppressive disease and have poor prognosis. This report aims to describe a case of multi-cystic peritoneal echinococcosis in a patient under antiviral treatment for HIV for almost ten years, who received albendazole, underwent surgery and progressed favorably. This would be the first Peruvian report of a person with HIV and cystic echinococcosis.

Morphology of Echinococcus granulosus protoscolex / Morfología de los Protoescolex de echinococcus granulosus

SUMMARY: Echinococcus granulosus (E. granulosus), is a tapeworm that spreads between intermediate and definitive hosts through the ingestion of fecal matter contaminated with the parasite's eggs. The life cycle consists of differentiation from eggs to oncospheres to embryos, which eventually form cysts in organs like the liver, lungs and others. Within these cysts are protoscolices, an intermediate stage of the parasite which develop into adult tapeworms once they infect their definitive hosts. When these hydatid cysts form in humans, it is known as Cystic Echinococcosis (CE). This disease is treated through surgical excision of the cysts and or chemotherapy with benzimidazole compounds. Understanding the morphology of the intermediate developmental stage of E. granulosus, protoscolex stage, can allow researchers to identify defining structural changes and protein functions that could be used to develop treatment modalities for CE. Unique characteristics in the tegumental surface during the protoescolex stage and proteins associated with cyst fertility have all been identified in previous research studies and bring researchers closer to understanding the underlying mechanisms of E. granulosus development, and consequently, means to disrupt it to achieve better control of the disease.

El Echinococcus granulosus (E. granulosus), es un cestodo que se propaga entre huéspedes intermedios y definitivos a través de la ingestión de materia fecal contaminada con los huevos del parásito. El ciclo de vida consiste en la diferenciación de huevos a oncosferas y embriones, que finalmente forman quistes en órganos como el hígado, los pulmones y otros. Dentro de estos quistes hay protoescólices, una etapa intermedia del parásito que se convierte en su forma adulta (tenia), una vez que infectan a sus huéspedes definitivos. Cuando estos quistes hidatídicos se desarrollan en seres humanos, se les conoce como equinococosis quística (EC). Esta enfermedad se trata mediante la extirpación quirúrgica de los quistes o la quimioterapia con compuestos benzimidazólicos. La comprensión de la morfología de la etapa de desarrollo intermedia del E. granulosus y la etapa de protosclex, puede permitir a los investigadores identificar cambios estructurales definidos y funciones de proteínas que podrían usarse para desarrollar modalidades de tratamiento para la CE. Las características únicas en la superficie tegumentaria durante la etapa de protoescolex y las proteínas asociadas con la fertilidad del quiste se han identificado en estudios de investigación anteriores y acercan a los investigadores a la comprensión de los mecanismos subyacentes del desarrollo del E. granulosus y, en consecuencia, los medios para interrumpirlo para lograr un mejor control de la enfermedad.

Hidatidosis subcutánea primaria

La hidatidosis o equinococosis quística es una zoonosis parasitaria endémica causada por el estadio larvario del cestode Echinococcus granulosus. El hígado y el pulmón son los órganos con afección más frecuente. Su ubicación subcutánea es una entidad rara, poco descrita, y por ende un reto diagnóstico. Describimos el caso de una mujer, de 18 años de edad, procedente de un área endémica, que presentó un quiste hidatídico primario supraclavicular.

Hydatid disease or cystic echinococcosis is an endemic parasitic zoonosis caused by the larval stage of the cestode Echinococcus granulosus, the liver and lung being the most frequently affected organs. Its subcutaneous location is a rare entity, little described, and therefore a diagnostic challenge. We describe the case of an 18-year-old woman from an endemic area who presented with a primary supraclavicular hydatid cyst.

Hidatidosis pancreática en una niña de 5 años / Pancreatic echinococcosis in a 5-year-old girl

La hidatidosis pancreática representa el 0,2-0,6 % de los casos, siendo la población pediátrica la de mayor riesgo. Las lesiones suelen localizarse en cabeza del páncreas (50-58 %); la localización en cuerpo y cola del páncreas se encuentra en el 24-34 % y el 19 %, respectivamente. Dada la posibilidad de complicaciones, suele realizarse tratamiento quirúrgico. Se sugiriere indicar albendazol antes y después del acto quirúrgico por los riesgos de ruptura y diseminación de los protoescólices. Se presenta el caso de una niña de 5 años de edad con dolor abdominal progresivo y lesión quística en páncreas compatible con hidatidosis en la ultrasonografía. En la tomografía computada se observa compresión de la vía biliar. La hemoaglutinación indirecta fue negativa. Presentó elevación de la bilirrubina total, con franco predominio de bilirrubina directa, y aumento de enzimas hepáticas. Se realizó laparotomía exploradora, colecistectomía y destechamiento del quiste. Evolucionó favorablemente, continuó con albendazol durante 3 meses luego de la cirugía.

Pancreatic echinococcosis accounts for 0.2­0.6% of cases, with the pediatric population being at a higher risk. Most commonly, pancreatic lesions occur in the head of the pancreas (50­58%); and in the body and tail in 24­34% and 19% of cases, respectively. Given the potential complications, surgery is usually performed. Albendazole is recommended before and after the surgery due to the risks for rupture and dissemination of protoscolices. Here we describe the case of a 5-year-old girl with progressive abdominal pain and cystic lesion in the pancreas compatible with echinococcosis in the ultrasound. The computed tomography showed bile duct compression. Indirect hemagglutination was negative. She had elevated total bilirubin, with a clear predominance of direct bilirubin, and high liver enzymes. Exploratory laparotomy, cholecystectomy, and unroofing of the cyst were performed. The patient had a favorable course and continued with albendazole for 3 months after the surgery.

Off-Pump Resection of Giant Intramural Left Ventricular Hydatid Cyst by Pleuropericardial Approach: a Case Report

ABSTRACT Primary cardiac hydatid cyst is a rare and fatal pathology, especially when involving the left ventricular free wall. A 44-year-old male was diagnosed with large intramural left ventricular hydatid cyst with wall thickness of 6 mm at the thinnest point. Cyst was accessed through pleuropericardial approach (left pleura opened, followed by entry into cyst directly through adjacent pericardium without removing the pericardial adhesions) which resulted in easy entry into the cyst, mitigating the risk of mechanical injury. This case report highlights that with detailed evaluation, cardiac hydatidosis can be addressed with off-pump technique, reducing the anaphylaxis risks and cardiopulmonary bypass-related effects.

Equinococosis esplénica primaria con breve revisión de literatura: a propósito de un caso

Introducción: La equinococosis esplénica es una enfermedad zoonótica adquirida de forma accidental por el humano como huésped intermediario. Reporte de caso: paciente mujer de 26 años de edad, con dolor abdominal localizado en hipocondrio izquierdo, moderada intensidad, calmaba con antiespasmódicos endovenosos; antecedente de dolor abdominal de larga data y procedente de región de Huancavelica, Perú hace 6 años. En examen clínico del abdomen: ruidos hidroaéreos; presentes, simétrico, blando, depresible, doloroso a la palpación en hipocondrio izquierdo, impresiona esplenomegalia, timpanismo conservado; en ecografía menciona quiste hidatídico a nivel del bazo Gharbi IV; en tomografía abdominopélvica con contraste muestra bazo con lesión quística heterogénea, de pared parcialmente calcificada y áreas de densidad grasa que se extiende hasta ligamento gastroesplénico, con diámetro de 73 mm x 54 mm; concluyendo equinococosis extrahepática (equinococosis esplénica), realizándose esplenectomía total. Conclusión: enfermedad rara, incluso en áreas endémicas, que plantea desafíos para su diagnóstico y tratamiento.

SUMMARY Introduction: Splenic echinococcosis is a zoonotic disease accidentally acquired by humans as an intermediate host. Case report: a 26-year-old female patient with abdominal pain located in the left hypochondrium, moderate intensity, calmed with intravenous antispasmodics; a history of long-standing abdominal pain and from the Huancavelica region, Peru, 6 years ago. On clinical examination of the abdomen: hydro-air sounds; present, symmetrical, soft, depressible, painful on palpation in the left hypochondrium, impression of splenomegaly, preserved tympany; the ultrasound mentions a hydatid cyst at the level of the spleen Gharbi IV; Contrast-enhanced abdominal and pelvic tomography shows a spleen with a heterogeneous cystic lesion, with a partially calcified wall and areas of fatty density that extend to the gastrosplenic ligament, with a diameter of 73 mm x 54 mm; concluding extrahepatic echinococcosis (splenic echinococcosis), performing total splenectomy. Conclusion: rare disease, even in endemic areas, which poses challenges for its diagnosis and treatment.

Clinical efficacy of da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis / 中华消化外科杂志

Objective:To investigate the clinical efficacy of da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 7 patients who underwent da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis in Xinjiang Uiger Municipal People′s Hospital from October 2019 to July 2021 were collected. There were 3 males and 4 females, aged (43±12)years. Observation indicators: (1) surgical situations; (2) complications; (3) follow-up. Mea-surement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations. All 7 patients underwent da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis successfully, without conversion to laparotomy and laparoscopic surgery. None of the 7 patients underwent intraoperative blood transfusion and the operation time, volume of intraoperative blood loss, time to postoperative first and flatus, time to postoperative initial liquid food intake, time to postoperative abdominal drainage tube removal, time to postoperative urethral catheter removal, duration of postoperative hospital stay of 7 patients was (225±45)minutes, 100(range, 50-200)mL, (1.9±0.7)days, (4.2±1.2)days, (7±4)days, (2.9±0.8)days, (7±4)days, respectively. (2) Complications. None of the 7 patients had postoperative complications such as bile leakage, abdominal hemorrhage, incision infection, hydatid cavity infection, secondary operation, intestinal obstruction, pulmonary infection and deep venous thrombosis of lower limbs. (3) Follow-up. All 7 patients were followed up for 7 (range, 3-12) months. None of the 7 patients had recurrence of hepatic echinococcosis or peritoneal implantation and incision implantation, and all patients survived during follow-up.Conclusion:da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis is safe and feasible.

Research progress in microRNA as a novel diagnostic marker for bone echinococcosis / 国际生物医学工程杂志

Bone echinococcosis is usually caused by Echinococcus granulosus and E. multilocularis. People become infected when they eat food or water contaminated with the eggs. Treatment of bone echinococcosis usually includes surgery and medication, but the lengthy and costly treatment imposes a heavy burden on patients. MicroRNAs (miRNA) are known to be involved in a variety of biological processes and host-host interactions, including development, cell growth and death, lifespan-related target regulation, transcription, signal transduction, and cell motility, which will help us find new strategies and targets for the treatment and control of osteonechoconiosis. For further understanding of bone echinococcosis, it is important to understand the molecular basis of E. multilocularis development in both final and intermediate hosts. The miRNA found in E. granulosus and E. multilocularis have gene and developmental stage specificity in their respective host expression regulation. In this review paper, the progress of research on miRNA as a novel diagnostic marker for osteoblastic echinococcosis is reviewed.

Progress of researches on albendazole for treatment of alveolar echinococcosis / 中国血吸虫病防治杂志

Alveolar echinococcosis, caused by Echinococcus multilocularis infection, is a highly deadly zoonotic parasitic disease. As a benzimidazole compound, albendazole has a strong and broad-spectrum anti-parasitic action. For alveolar echinococcosis patients that are unwilling to receive surgical treatment, lose the timing for surgery, or are intolerant to surgery due to poor physical status, administration of albendazole may delay disease progression. Recently, a large number of advances have been achieved in experimental studies on alveolar echinococcosis. In order to increase the understanding of the therapeutic efficacy of albendazole for alveolar echinococcosis, this review summarizes the advances in albendazole treatment for alveolar echinococcosis, so as to provide insights into the clinical treatment of alveolar echinococcosis with albendazole.

Temporal trends in disease burden of major human parasitic diseases in China from 1990 to 2019 / 中国血吸虫病防治杂志

Objective To analysize the temporal trends in the disease burden of major human parasitic diseases in China from 1990 to 2019, so as to provide the evidence for improving the parasitic disease control strategy in China.. Methods The disability-adjusted life years (DALYs) of malaria, intestinal nematode infections, schistosomiasis, food-borne trematodiases, cysticercosis and echinococcosis in China from 1990 to 2019 were captured from the Global Burden of Disease Study 2019 (GBD 2019), and age- and gender-specific DALYs of parasitic diseases were estimated. The temporal trends in DALYs of malaria, intestinal nematode infections, schistosomiasis, food-borne trematodiases, cysticercosis and echinococcosis were evaluated in China from 1990 to 2019 using average annual percent change (AAPC) with Joinpoint regression analysis. Results The DALYs were 643 836.42 person-years due to food-borne trematodiases, 156 853.03 person-years due to cysticercosis, 79 764.62 person-years due to schistosomiasis, 70 989.73 person-years due to intestinal nematode infections, 4 258.61 person-years due to echinococcosis and 264.86 person-years due to malaria in China in 2019, respectively. The overall DALYs of six parasitic diseases were higher among men (546 441.93 person-years) than among women (409 525.33 person-years), and were greater among adults at ages of 14 to 65 years (684 780.84 person-years) than among children at 14 years and lower (35 437.38 person-years) and the elderly at ages of 65 years and older (235 749.04 person-years). During the period from 1990 to 2019, food-borne trematodiases were the leading cause of DALYs among the six parasitic diseases, and cysticercosis shifted from the fourth leading cause in 1990 to the second leading cause of DALYs in China in 2019, while intestinal nematode infections shifted from the second leading cause in 1990 to the fourth leading cause of DALYs in 2019. The DALYs of major human parasitic diseases appeared an overall tendency towards a decline in China from 1990 to 2019, with the fastest drop seen in DALYs due to malaria (AAPC = −19.6%, P = 0.003), followed by due to intestinal nematode infections (AAPC = −8.2%, P < 0.001) and schistosomiasis (AAPC = −3.1%, P < 0.001), and a slow decline was seen in the DALYs of food-borne trematodiases (AAPC = −1.0%, P < 0.001), while there were no significant decrease in the DALYs of echinococcosis (AAPC = −0.5%, P = 0.264) and the DALYs of cysticercosis appeared a tendency towards a rise (AAPC = 0.7%, P < 0.001). Conclusions The disease burden of major human parasitic diseases appeared an overall tendency towards a decline in China from 1990 to 2019, with a high disease burden seen due to food-borne parasitic diseases, no remarkable reduction seen in echinococcosis, and a tendency towards a rise seen in cysticercosis. It is recommended to focus on echinococcosis control, and continue to consolidate the control achievements of other major human parasitic diseases in China; meanwhile, the surveillance and prevention of food-borne parasitic diseases should be reinforced.

Advances in the application of three-dimensional visualization technique in hepatic alveolar echinococcosis / 临床肝胆病杂志

Hepatic alveolar echinococcosis (HAE) is a parasitic disease caused by Echinococcus multilocularis infection and has wide distribution and great harm in China. At present, ultrasound, CT, and MRI are the main radiological examination methods for HAE, with certain limitations in preoperative diagnosis and evaluation. This article introduces the guiding effect of three-dimensional visualization technique and its derivative technologies in the accurate diagnosis and preoperative evaluation of HAE, so as to provide help for the clinical diagnosis and treatment of HAE in the future.

Immune escape of hepatic echinococcosis based on the PD-1/PD-L1 signaling pathway / 临床肝胆病杂志

PD-1 and PD-L1 together constitute the stimulus signaling pathway of adaptive immune response, which has been widely used in the research on the mechanism of tumor immune escape and tumor therapy. At the same time, its signaling pathway has been proved to be closely associated with the immune escape of hepatic echinococcosis. This article reviews the chemical structures of PD-1 and PD-L1, the mechanism of the PD-1/PD-L1 signaling pathway, and the role of the PD-1/PD-L1 signaling pathway in immune escape of hepatic echinococcosis, i.e., the PD-1/PD-L1 signaling pathway is involved in immune escape of hepatic echinococcosis under three theories, so as to explore the immune escape of hepatic echinococcosis from a new perspective and provide a basis and ideas for the diagnosis and treatment of hepatic echinococcosis.

Cisto Hidático Cardíaco: Uma Causa Incomum de Bloqueio Atrioventricular Total / Cardiac Hydatid Cyst: An Uncommon Cause of Complete Atrioventricular Block

Resumo A hidatidose é uma zoonose causada pelo Echinococcus granulosus, levando à formação de cistos nos órgãos acometidos. O envolvimento cardíaco é raro e pode causar diversas complicações secundárias à ruptura, embolização ou compressão. Seu diagnóstico é desafiador, sendo confirmado por meio de dados relacionados a manifestações clínicas, exposição ambiental, exames laboratoriais e de imagem. A ressecção cirúrgica é necessária na maioria dos casos, sendo indicada a associação com terapia antiparasitária. No presente artigo, descreve-se um caso de cisto hidático cardíaco associado a bloqueio atrioventricular total em paciente jovem, com necessidade de implante de marcapasso, uma apresentação atípica e pouco relatada na literatura.

Abstract Hydatidosis is a zoonosis caused by Echinococcus granulosus, leading to the formation of cysts on involved organs. Cardiac involvement is rare and can cause a wide range of complications secondary to rupture, embolization, or compression. Its diagnosis is challenging, and is generally confirmed through data related to clinical manifestations, environmental exposure, and laboratory and imaging exams. Surgical removal is necessary in most cases, in which an association with antiparasite therapy is recommended. The present article describes a case of a cardiac hydatid cyst associated with a complete atrioventricular block (AVB) in a young adult patient, with the need for a pacemaker implant, an atypical presentation, and scarce reports in the literature.

Hydatid cyst involving the mandible ramus

ABSTRACT Parasitic infections rarely involve the oral and maxillofacial regions and pose a diagnostic challenge when they do. Hydatid cysts are parasitic cysts caused by Echinococcus granulosus. Intraosseous involvement is observed in 3% of cases, of which only 2-6% are in the maxillofacial region. A scientific literature search revealed only seven cases involving the mandible. We report a rare case in a 16-year-old female patient who presented with facial asymmetry and well-defined radiolucency of the ramus. Our findings will help in understanding the diagnostic issues caused by non-specific presentation and difficulties in suspecting such a rare diagnosis as echinococcosis of the oral or maxillofacial region. A thorough systemic investigation is essential as 20-30% of these cases show multiorgan involvement.